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Individual

DR. TYRONE CECIL MALLOY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
4201 RAINBOW DR, DECATUR, GA 30034-2302
(404) 534-0035
(404) 286-7100
Mailing address
4201 RAINBOW DR, DECATUR, GA 30034-2302
(404) 534-0035
(404) 286-7100

Taxonomy

Speciality
Code
Description
License number
State
207VG0400X
Gynecology Physician
Primary
23086
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000227741A
GA
Enumeration date
09/06/2006
Last updated
09/23/2008
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