Provider Demographics
NPI:1134277478
Name:MALONE, JEFFREY A (MD)
Entity type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:A
Last Name:MALONE
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:5356 STADIUM TRACE PKWY
Mailing Address - Street 2:SUITE 200
Mailing Address - City:HOOVER
Mailing Address - State:AL
Mailing Address - Zip Code:35244-5607
Mailing Address - Country:US
Mailing Address - Phone:205-985-9424
Mailing Address - Fax:205-985-9465
Practice Address - Street 1:5356 STADIUM TRACE PKWY
Practice Address - Street 2:SUITE 200
Practice Address - City:HOOVER
Practice Address - State:AL
Practice Address - Zip Code:35244-5607
Practice Address - Country:US
Practice Address - Phone:205-985-9424
Practice Address - Fax:205-985-9465
Is Sole Proprietor?:No
Enumeration Date:2007-01-05
Last Update Date:2015-07-14
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Provider Licenses
StateLicense IDTaxonomies
AL147362080A0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALE23354Medicare UPIN