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NPI Code Detail

MEDICARE: WILLIAM JAMES MALLON M.D.

MEDICARE: WILLIAM JAMES MALLON M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207X00000XOrthopaedic Surgery Physician39019NC
2207XX0005XSports Medicine (Orthopaedic Surgery) Physician39019NC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1366437048
Entity Type Code : Individual
Provider Name (Legal Business Name) : WILLIAM JAMES MALLON M.D.
Provider Business Mailing Address
First Line : 120 WILLIAM PENN PLZ
Second Line :
City : DURHAM
State : NC
Zip : 27704-2150
Country : US
Telephone Number : 919-220-5255
Fax Number : 919-313-1276
Provider Business Practice Location Address
First Line : 120 WILLIAM PENN PLZ
Second Line :
City : DURHAM
State : NC
Zip : 27704-2150
Country : US
Telephone Number : 919-220-5255
Fax Number : 919-313-1276
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/19/2005
Last Update Date : 06/21/2012

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Directions to “ WILLIAM JAMES MALLON M.D.” Practice Location

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