Individual
KEATHERN SCOTT MALONE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3051 WATSON BLVD, SUITE400, WARNER ROBINS, GA 31093-8536
(478) 953-4563
(478) 953-4616
Mailing address
3051 WATSON BLVD, SUITE 400, WARNER ROBINS, GA 31093-8536
(478) 971-2227
(478) 953-4677
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
044524
GA
2081S0010X
Sports Medicine (Physical Medicine & Rehabilitation) Physician
Primary
044534
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000775607E
—
GA
Enumeration date
05/18/2006
Last updated
08/13/2012
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