Healthcare Provider Details

I. General information

NPI: 1013018720
Provider Name (Legal Business Name): YOLANDA MALONE-GILBERT M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/26/2006
Last Update Date: 02/25/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2340 PATRICK HENRY PKWY STE 225
MCDONOUGH GA
30253-4214
US

IV. Provider business mailing address

2340 PATRICK HENRY PKWY STE 225
MCDONOUGH GA
30253-4214
US

V. Phone/Fax

Practice location:
  • Phone: 770-389-8100
  • Fax: 770-389-3030
Mailing address:
  • Phone: 770-389-8100
  • Fax: 770-389-3030

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number050537
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number050537
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: