Provider Demographics
NPI:1598780702
Name:MALONE, PATRICIA JO THOMSON (MD)
Entity Type:Individual
Prefix:DR
First Name:PATRICIA
Middle Name:JO THOMSON
Last Name:MALONE
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:1247 SUNCREST TOWN CENTRE DR
Mailing Address - Street 2:
Mailing Address - City:MORGANTOWN
Mailing Address - State:WV
Mailing Address - Zip Code:26505-1876
Mailing Address - Country:US
Mailing Address - Phone:304-599-8000
Mailing Address - Fax:304-599-8003
Practice Address - Street 1:9000 COOMBS FARM RD STE 102
Practice Address - Street 2:
Practice Address - City:MORGANTOWN
Practice Address - State:WV
Practice Address - Zip Code:26508-1150
Practice Address - Country:US
Practice Address - Phone:304-599-8000
Practice Address - Fax:304-599-8003
Is Sole Proprietor?:No
Enumeration Date:2006-07-12
Last Update Date:2020-04-01
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Provider Licenses
StateLicense IDTaxonomies
WV22314208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV3810006394Medicaid