Individual
DR. TIMOTHY N. MALAVOLTI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.P.M.
Contact information
Practice address
9318 S TOLEDO CT, TULSA, OK 74137-2746
(918) 294-3668
Mailing address
9318 S TOLEDO CT, TULSA, OK 74137-2746
(918) 294-3668
Taxonomy
Speciality
Code
Description
License number
State
213ES0131X
Foot Surgery Podiatrist
Primary
158
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100779850
—
OK
05
—
100779850A
—
OK
01
—
P01770667
RAILROAD MEDICARE
OK
Enumeration date
10/23/2006
Last updated
02/16/2017
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