Individual
DR. GEORGE EDWARD MALLORY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
17606 NATHANS DR, TAMPA, FL 33647-2272
(813) 997-1241
(813) 973-4664
Mailing address
8955 MAGNOLIA CHASE CIR, TAMPA, FL 33647-2220
(813) 997-1241
(813) 973-4664
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
OS0005771
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
370789001
—
FL
01
—
80714
BCBS
FL
Enumeration date
03/08/2006
Last updated
11/24/2009
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