Healthcare Provider Details

I. General information

NPI: 1225248099
Provider Name (Legal Business Name): MALONE FOOT AND ANKLE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/23/2007
Last Update Date: 03/28/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

691 LANIER PARK DR SUITE B
GAINESVILLE GA
30501-2060
US

IV. Provider business mailing address

PO BOX 908325
GAINESVILLE GA
30501-0921
US

V. Phone/Fax

Practice location:
  • Phone: 770-533-9115
  • Fax: 770-533-9922
Mailing address:
  • Phone: 770-533-9115
  • Fax: 770-533-9922

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number
License Number State

VIII. Authorized Official

Name: DR. MARIA MALONE
Title or Position: OWNER
Credential: D.P.M.
Phone: 770-533-9115