Healthcare Provider Details

I. General information

NPI: 1336456086
Provider Name (Legal Business Name): JOSEPH D MOTT MDPC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/01/2010
Last Update Date: 09/01/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 W CHILTON ST
CHANDLER AZ
85225-7110
US

IV. Provider business mailing address

301 W CHILTON ST
CHANDLER AZ
85225-7110
US

V. Phone/Fax

Practice location:
  • Phone: 480-892-6619
  • Fax: 866-382-4355
Mailing address:
  • Phone: 480-892-6619
  • Fax: 866-382-4355

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number07589
License Number StateAZ

VIII. Authorized Official

Name: DR. JOSEPH DENNIS MOTT
Title or Position: PHYSICIAN/OWNER
Credential: MD
Phone: 480-892-6619