Healthcare Provider Details

I. General information

NPI: 1811959554
Provider Name (Legal Business Name): JAMES M MALONE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/06/2006
Last Update Date: 10/12/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10290 NORTH 92ND STREET SUITE 300
SCOTTSDALE AZ
85258
US

IV. Provider business mailing address

108 WEST UNIVERSITY DRIVE
MESA AZ
85201-5818
US

V. Phone/Fax

Practice location:
  • Phone: 480-657-7610
  • Fax: 480-657-0340
Mailing address:
  • Phone: 480-649-3774
  • Fax: 480-649-3685

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License Number9970
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: