Individual
DR. MARK S. MALONE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
CORNER OF ROUTE N12 AND N7, FORT DEFIANCE, AZ 86504
(928) 729-8000
Mailing address
PO BOX 649, FORT DEFIANCE, AZ 86504-0649
(928) 729-8000
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
E1291
AR
207Q00000X
Family Medicine Physician
Primary
J6560
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
131726001
—
AR
05
—
203997002
—
MO
01
—
5K474
AR BLUE SHIELD #
AR
Enumeration date
10/14/2006
Last updated
10/31/2025
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