=====================================================
General NPI Number Information
=====================================================
NPI Number | 1619156908
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | JOSEPH A. MOTTO, MD
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/02/2007
-----------------------------------------------------
Last Update Date | 09/10/2008
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 4355 HIGHWAY 58 SUITE 107A
-----------------------------------------------------
City | CHATTANOOGA
-----------------------------------------------------
State | TN
-----------------------------------------------------
Zip | 37416-2939
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 423-842-5260
-----------------------------------------------------
Fax | 423-899-5632
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 23503
-----------------------------------------------------
City | CHATTANOOGA
-----------------------------------------------------
State | TN
-----------------------------------------------------
Zip | 37422-3503
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 423-842-5260
-----------------------------------------------------
Fax | 423-899-5632
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | ACCOUNT MANAGER
-----------------------------------------------------
Name | MR. JONATHAN DEVLIN
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 423-443-3524
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207Y00000X
-----------------------------------------------------
Taxonomy Name | Otolaryngology Physician
-----------------------------------------------------
License Number | MD0000014144
-----------------------------------------------------
License Number State | TN
-----------------------------------------------------