Individual
MATTHEW LAYNE MALLORY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
60 E MONTE PAINTER DR, FAYETTEVILLE, AR 72703-4014
(479) 587-1700
(479) 587-1366
Mailing address
222 E DUNBAR LN APT 326, FAYETTEVILLE, AR 72703-3276
(434) 258-4408
(479) 587-1366
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
0442072
KS
2085R0001X
Radiation Oncology Physician
2019024443
MO
2085R0001X
Radiation Oncology Physician
Primary
E-14474
AR
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200993230A
—
OK
05
—
269386001
—
AR
Enumeration date
04/24/2014
Last updated
10/08/2024
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us