Organization
MARK A OMALLEY DO PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARK ALAN OMALLEY DO (PRESIDENT)
(602) 862-9390
Entity
Organization
Contact information
Practice address
3420 EAST ANDERSON DRIVE, PHOENIX, AZ 85032
(602) 862-9390
Mailing address
4757 EAST GREENWAY ROAD 107B, PMB 189, PHOENIX, AZ 85032-8510
(602) 862-9390
(602) 862-9390
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
3364
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
438582
AHCCCS
AZ
Enumeration date
04/06/2006
Last updated
11/02/2007
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