Provider Demographics
NPI:1467882977
Name:MALCOLM, RON IAN (EDD)
Entity Type:Individual
Prefix:DR
First Name:RON
Middle Name:IAN
Last Name:MALCOLM
Suffix:
Gender:M
Credentials:EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2532 N 107TH ST
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:KS
Mailing Address - Zip Code:66109-3630
Mailing Address - Country:US
Mailing Address - Phone:913-912-2714
Mailing Address - Fax:
Practice Address - Street 1:2532 N 107TH ST
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:KS
Practice Address - Zip Code:66109-3630
Practice Address - Country:US
Practice Address - Phone:913-306-6027
Practice Address - Fax:913-727-1602
Is Sole Proprietor?:No
Enumeration Date:2013-11-19
Last Update Date:2015-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst