Individual
DR. WILLIAM OLIN MALLOW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
803 N JEFFERSON ST, ALBANY, GA 31701-2373
(229) 312-7800
Mailing address
2700 MCCALL CT, ALBANY, GA 31721-9193
(864) 344-0265
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
056900
GA
207P00000X
Emergency Medicine Physician
16019
SC
207Q00000X
Family Medicine Physician
16019
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003122498F
—
GA
05
—
160195
—
SC
Enumeration date
05/05/2006
Last updated
08/16/2012
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