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General NPI Number Information
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NPI Number | 1326069865
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Entity Type | Individual
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Provider Name | VICKIE CORTESSA MOTLEY MD
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Gender | Female
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Dates
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Enumeration Date | 07/21/2006
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Last Update Date | 12/11/2025
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Provider Practice Location Address
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Address Line | 299 BENJAMIN HL
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City | FITZGERALD
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State | GA
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Zip | 31750-8696
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Country | US
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Telephone | 229-423-5437
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Fax |
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Provider Business Mailing Address
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Address Line | 111 LEXI LN
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City | FITZGERALD
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State | GA
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Zip | 31750-8717
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Country | US
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Telephone | 757-880-0431
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 0101038366
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License Number State | GA
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