Organization
DONALD W MALONE MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DONALD WALTER MALONE MD (PRESIDENT)
(580) 380-1972
Entity
Organization
Contact information
Practice address
1705 N WASHINGTON AVE, SUITE C, DURANT, OK 74701-2100
(580) 380-1972
(580) 920-8079
Mailing address
1705 N WASHINGTON AVE, SUITE C, DURANT, OK 74701-2100
(580) 380-1972
(580) 920-8079
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
100150330B
OSU MEDICAID ID #
OK
05
—
200087560A
—
OK
01
—
23602
OK LICENSE
OK
01
—
2868440001
DME MEDICARE
OK
01
—
611415200
FEDERAL WC-OW
OK
01
—
DF1904
RAILROAD-MEDICARE
OK
01
—
P00345588
RAILROAD PIN
OK
Enumeration date
05/31/2006
Last updated
05/29/2008
Update your record
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