Provider Demographics
NPI:1912952136
Name:MALONE, MATTHEW T (DO)
Entity Type:Individual
Prefix:
First Name:MATTHEW
Middle Name:T
Last Name:MALONE
Suffix:
Gender:M
Credentials:DO
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Mailing Address - Street 1:1551 E TANGERINE RD
Mailing Address - Street 2:
Mailing Address - City:ORO VALLEY
Mailing Address - State:AZ
Mailing Address - Zip Code:85755-6213
Mailing Address - Country:US
Mailing Address - Phone:520-901-3539
Mailing Address - Fax:520-901-3654
Practice Address - Street 1:1551 E TANGERINE RD
Practice Address - Street 2:
Practice Address - City:ORO VALLEY
Practice Address - State:AZ
Practice Address - Zip Code:85755-6213
Practice Address - Country:US
Practice Address - Phone:520-901-3539
Practice Address - Fax:520-901-3654
Is Sole Proprietor?:No
Enumeration Date:2006-05-24
Last Update Date:2021-09-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
SD57942084P0805X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0805XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyGeriatric Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD2152654OtherARAZ/ AMERICA'S PPO
SD57108C011OtherWPS TRICARE
MN156692000Medicaid
ND12200Medicaid
SD5794OtherDAKOTACARE
SD250264OtherMIDLANDS CHOICE
SD370624200OtherDEPT OF LABOR
NE46022474352Medicaid
MN99G68MAOtherCC SYSTEMS/ BLUE PLUS
SD4994072OtherBLUE CROSS
MN040121002OtherPRIMEWEST
IA0722587Medicaid
SD53583OtherSANFORD HEALTH PLAN
SDHP42927OtherHEALTHPARTNERS
SD412991041698OtherPREFERRED ONE
SD53583OtherSANFORD HEALTH PLAN
IA0722587Medicaid