Individual
JORDAN MALLERY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
6001 RESEARCH PARK BLVD, MADISON, WI 53719-1176
(608) 232-3171
Mailing address
6001 RESEARCH PARK BLVD, MADISON, WI 53719-1176
(608) 232-3171
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
RL16719
ND
2084P0800X
Psychiatry Physician
Primary
REL100660-851
WI
Other
Enumeration date
07/31/2020
Last updated
05/12/2026
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