Provider Demographics
NPI:1215908868
Name:MOTZ, GREGG ANDREW (MD)
Entity type:Individual
Prefix:DR
First Name:GREGG
Middle Name:ANDREW
Last Name:MOTZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 370
Mailing Address - Street 2:
Mailing Address - City:FORTSON
Mailing Address - State:GA
Mailing Address - Zip Code:31808-0370
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:706-494-3008
Practice Address - Street 1:353 NEW SHACKLE ISLAND RD STE 141C
Practice Address - Street 2:
Practice Address - City:HENDERSONVILLE
Practice Address - State:TN
Practice Address - Zip Code:37075-2366
Practice Address - Country:US
Practice Address - Phone:615-826-7171
Practice Address - Fax:615-826-7170
Is Sole Proprietor?:No
Enumeration Date:2006-01-31
Last Update Date:2020-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN37075207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN4054396OtherBCBS
TN3882441Medicaid
H18559Medicare UPIN
TN0922510008Medicare NSC
TN200046324Medicare PIN
TN3882441Medicaid