Doctor Name: | MR. MALLORY T HARLING |
NPI Number: | 1154397685 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MD |
License Number: | 16141 |
Business Practice Address: | 1450 E Valley Rd Ste 105 Basalt, CO - 816218352 |
Business Phone Number: | 9709271717 |
Business Fax Number: | 9709276164 |
Mailing Address: | 1450 E Valley Rd Ste 105, BASALT |
State: | CO |
Postal Code: | 816218352 |
Phone Number: | 9709271717 |
Fax Number: | 9709276164 |
NPI Enumeration Date: | 02/24/2006 |
NPI Last Update Date: | 03/06/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 207VG0400X |
License Number: | 16141 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | CO |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | Obstetrics & Gynecology |
Taxonomy Specialization: | Gynecology |
Taxonomy Definition: |