Mallisee, Thomas A.

Mallisee, Thomas A. is an individual health care provider with primary practice located at 1111 6Th Ave , Des Moines IA 50314-2613. He recently has only one registered license in Allopathic & Osteopathic Physicians / Body Imaging, which is considered as his primary health care specialty. Mallisee, Thomas A. can be contacted via phone (515) 643-2667.

Contact Information

Primary practice address
1111 6Th Ave Des Moines IA 50314-2613
Phone: (515) 643-2667
Fax: (515) 643-2978
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Body Imaging 2085B0100X 32854 Iowa

Profile Details

NPI number 1639167042
LBN Legal business name Mallisee, Thomas A.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 10th, 2005
Last updated Jul 8th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1639167042 NPPES
Iowa MEDICAID 0192344

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