MEDICARE: DR. CARRIE F ASH-MOTT MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	43426	AZ
2	207Q00000X	Family Medicine Physician	16202	NV

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1578786406
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CARRIE F ASH-MOTT MD

Provider Business Mailing Address
First Line	:	PO BOX 616788
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32861-6788
Country	:	US
Telephone Number	:	407-447-7120
Fax Number	:	407-770-0661

Provider Business Practice Location Address
First Line	:	1766 E CHARLESTON BLVD
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89104-1945
Country	:	US
Telephone Number	:	702-843-2440
Fax Number	:	833-749-0349

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/10/2007
Last Update Date	:	11/13/2020

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