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Individual

ROSLYN V MALLORY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
70 DOCTORS DR, PANAMA CITY, FL 32405-4517
(850) 785-1517
(850) 784-1271
Mailing address
70 DOCTORS DR, PANAMA CITY, FL 32405-4517
(850) 785-1517
(850) 784-1271

Taxonomy

Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
ME107856
FL
207VG0400X
Gynecology Physician
ME107856
FL
207VX0000X
Obstetrics Physician
ME107856
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
002800000
FL
01
149F4
BCBS
FL
Enumeration date
02/06/2008
Last updated
01/16/2014
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