Individual
DR. MARTHA A MALONE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
14520 E 104TH ST N, OWASSO, OK 74055-4843
(918) 695-1480
Mailing address
14520 E 104TH ST N, OWASSO, OK 74055-4843
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
262251
NY
208600000X
Surgery Physician
4503
OK
Other
Enumeration date
07/05/2007
Last updated
08/02/2011
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