Malone, Jay Randolph

Malone, Jay Randolph is an individual health care provider with primary practice located at 1 Childrens Pl Div Ped Critical Care Med, Saint Louis MO 63110-1002. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatrics, Allopathic & Osteopathic Physicians / Pediatric Critical Care Medicine. Allopathic & Osteopathic Physicians / Pediatric Critical Care Medicine is his primary health care specialty. Malone, Jay Randolph can be contacted via phone (314) 454-2527.

Contact Information

Primary practice address
1 Childrens Pl Div Ped Critical Care Med Saint Louis MO 63110-1002
Phone: (314) 454-2527
Fax: (314) 747-8880
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 2013021354 Missouri
Allopathic & Osteopathic Physicians / Pediatric Critical Care Medicine 2080P0203X 2013021354 Missouri

Profile Details

NPI number 1093940751
LBN Legal business name Malone, Jay Randolph
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 26th, 2009
Last updated Apr 25th, 2024 - about 7 months 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 1093940751 NPPES
Missouri MEDICAID 200032754

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