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Individual

GEORGE S MALONE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
OD

Contact information

Practice address
114 IRISH CEMETERY RD, TAZEWELL, TN 37879-3610
(423) 626-7249
(423) 626-6630
Mailing address
PO BOX 430, TAZEWELL, TN 37879-0430
(423) 626-7249
(423) 626-6630

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
T792
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3594654
TN
Enumeration date
01/20/2006
Last updated
03/03/2008
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