DR. Johanna T Mallare, MD

NPI #1821055278 in West Memphis, Arkansas

Provider Information

NPI Number: 1821055278
Entity Type: Individual
Name: DR. Johanna T Mallare, MD
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Pediatrics
Credential: MD
Enumeration Date: Apr 28, 2006
Last Updated: Oct 8, 2020

Practice Location

Address: 108 W TYLER AVE
City: West Memphis
State: Arkansas
ZIP Code: 72301-4221
Phone: (870) 732-1191

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Pediatrics	208000000X	Primary

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