| Doctor Name: | DR. DAVID B MALLORY |
| NPI Number: | 1093725368 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MD |
| License Number: | 10466 |
| Business Practice Address: | 1240 Sw 44th St Oklahoma City, OK - 731093604 |
| Business Phone Number: | 4056311527 |
| Business Fax Number: | 4056319930 |
| Mailing Address: | 12105 S Wentworth Pl, OKLAHOMA CITY |
| State: | OK |
| Postal Code: | 731704822 |
| Phone Number: | 4056916219 |
| Fax Number: | |
| NPI Enumeration Date: | 08/09/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 10466 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OK |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |