Motley, Mark Allen

Motley, Mark Allen is an sole proprietor health care provider with primary practice located at 1355 West Main St , Bellevue OH 44811. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Motley, Mark Allen can be contacted via phone (419) 483-7685.

Contact Information

Primary practice address
1355 West Main St Bellevue OH 44811
Phone: (419) 483-7685
Fax: (419) 483-4694
Website:
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Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X OPT.003300 Ohio

Profile Details

NPI number 1750494530
LBN Legal business name Motley, Mark Allen
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 16th, 2006
Last updated Dec 3rd, 2020 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1750494530 NPPES
Ohio MEDICAID 0333704
Ohio Other 1750494530
Ohio Other 791580458
Ohio Other 00130216
Ohio Other 00164996

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