Healthcare Provider Details

I. General information

NPI: 1316173347
Provider Name (Legal Business Name): SARAH A. MOTORNY D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/04/2009
Last Update Date: 02/01/2023
Certification Date: 02/01/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

687 LONG HOLLOW PIKE
GOODLETTSVILLE TN
37072-3450
US

IV. Provider business mailing address

687 LONG HOLLOW PIKE
GOODLETTSVILLE TN
37072-3450
US

V. Phone/Fax

Practice location:
  • Phone: 515-822-1320
  • Fax: 515-282-2332
Mailing address:
  • Phone: 515-822-1320
  • Fax: 515-282-2332

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberDO-R-8664
License Number StateIA
# 2
Primary TaxonomyY
Taxonomy Code207QA0401X
TaxonomyAddiction Medicine (Family Medicine) Physician
License NumberDO2537
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: