Provider Demographics
NPI:1295969632
Name:MALONE, MATTHEW PHILLIP (MD)
Entity type:Individual
Prefix:
First Name:MATTHEW
Middle Name:PHILLIP
Last Name:MALONE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1 CHILDRENS WAY
Mailing Address - Street 2:SLOT #512-12
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72202-3500
Mailing Address - Country:US
Mailing Address - Phone:501-364-1846
Mailing Address - Fax:501-364-3188
Practice Address - Street 1:1 CHILDRENS WAY
Practice Address - Street 2:SLOT #512-12
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72202-3500
Practice Address - Country:US
Practice Address - Phone:501-364-1846
Practice Address - Fax:501-364-3188
Is Sole Proprietor?:No
Enumeration Date:2009-05-13
Last Update Date:2016-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE-99452080P0203X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0203XAllopathic & Osteopathic PhysiciansPediatricsPediatric Critical Care Medicine