Healthcare Provider Details

I. General information

NPI: 1073552667
Provider Name (Legal Business Name): CHRISTOPHER T MALONEY JR. M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/06/2006
Last Update Date: 08/31/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3170 N SWAN RD
TUCSON AZ
85712-1227
US

IV. Provider business mailing address

PO BOX 13627
TUCSON AZ
85732-3627
US

V. Phone/Fax

Practice location:
  • Phone: 520-298-2325
  • Fax: 520-298-2328
Mailing address:
  • Phone: 520-750-7166
  • Fax: 520-886-1929

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License Number30130
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: