Healthcare Provider Details

I. General information

NPI: 1780845305
Provider Name (Legal Business Name): HEATHER JEAN MALONE MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/17/2008
Last Update Date: 03/07/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8781 N. PLATTE PURCHASE DRIVE
KANSAS CITY MO
64155
US

IV. Provider business mailing address

8781 N. PLATTE PURCHASE DRIVE
KANSAS CITY MO
64155
US

V. Phone/Fax

Practice location:
  • Phone: 816-587-3200
  • Fax: 816-587-7644
Mailing address:
  • Phone: 816-587-3200
  • Fax: 816-587-7644

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number5703
License Number StateNE
# 2
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number2010003236
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: