Provider Demographics
NPI:1225136369
Name:MALONE, ROBERT (RPT)
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:
Last Name:MALONE
Suffix:
Gender:M
Credentials:RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8331 MADISON BLVD.
Mailing Address - Street 2:SUITE 500
Mailing Address - City:MADISON
Mailing Address - State:AL
Mailing Address - Zip Code:35758-2068
Mailing Address - Country:US
Mailing Address - Phone:256-325-2070
Mailing Address - Fax:844-587-9612
Practice Address - Street 1:8331 MADISON BLVD.
Practice Address - Street 2:SUITE 500
Practice Address - City:MADISON
Practice Address - State:AL
Practice Address - Zip Code:35758-2068
Practice Address - Country:US
Practice Address - Phone:256-325-2070
Practice Address - Fax:844-587-9612
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2022-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL18209171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor