Provider Demographics
NPI:1932622750
Name:MALONE-DAVIS NEUROLOGY PLLC
Entity type:Organization
Organization Name:MALONE-DAVIS NEUROLOGY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:TOYA
Authorized Official - Middle Name:
Authorized Official - Last Name:MALONE-DAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:725-221-1568
Mailing Address - Street 1:7730 W CHEYENNE AVE STE 107
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89129-8412
Mailing Address - Country:US
Mailing Address - Phone:725-221-1568
Mailing Address - Fax:725-333-9218
Practice Address - Street 1:7730 W CHEYENNE AVE STE 107
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89129-8412
Practice Address - Country:US
Practice Address - Phone:725-221-1568
Practice Address - Fax:725-333-9218
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-07-24
Last Update Date:2024-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV165832084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1720297799OtherNPI