Provider Demographics
NPI:1316983505
Name:MOTLEY, WILLIAM WALKER III (MD)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:WALKER
Last Name:MOTLEY
Suffix:III
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:WALKER
Other - Middle Name:
Other - Last Name:MOTLEY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:3333 BURNET AVE # MLC4008
Mailing Address - Street 2:CINCINNATI CHILDREN'S HOSPITAL MEDICAL CENTER
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45229-3026
Mailing Address - Country:US
Mailing Address - Phone:513-636-4751
Mailing Address - Fax:513-636-7484
Practice Address - Street 1:3333 BURNET AVE # MLC4008
Practice Address - Street 2:CINCINNATI CHILDREN'S HOSPITAL MEDICAL CENTER
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45229-3026
Practice Address - Country:US
Practice Address - Phone:513-636-4751
Practice Address - Fax:513-636-7484
Is Sole Proprietor?:No
Enumeration Date:2006-06-22
Last Update Date:2014-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.075353207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL7299661Medicare ID - Type Unspecified
FLH56806Medicare UPIN