Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RE0101X | Endocrinologist (Diabetes Doctor) | 01031152A | IN |
NPI | 1083078943 |
---|---|
Provider Name | Dr. James K Malone |
First Address | Indianapolis, IN 46208-2636 |
Second Address | Indianapolis, IN 46208-2636 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/04/2016 |
Last Update Date | 07/04/2016 |