Individual
RONALD RAY MALLORY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
214 HOSPITAL CIR, BLAIRSVILLE, GA 30512-3102
(706) 745-2111
(706) 745-3114
Mailing address
214 HOSPITAL CIR, BLAIRSVILLE, GA 30512-3102
(706) 745-2111
(706) 745-3114
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
R095938
GA
Other
Enumeration date
10/10/2006
Last updated
07/08/2007
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