DR. JOHANNA T MALLARE MD - NPI 1821055278 - Pediatrics in West Memphis, AR

Q: What is Johanna Mallare's NPI number?

The NPI number for Johanna Mallare is 1821055278. It was assigned to this individual provider in the NPPES registry on April 28, 2006.

Q: What is Johanna Mallare's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Q: When was this NPI record last updated?

The NPPES record for Johanna Mallare was last updated on October 8, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

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About Dr. Johanna T Mallare Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. JOHANNA T MALLARE MD (NPI 1821055278) is an individual pediatrics provider in West Memphis, Arkansas, licensed in Arkansas (E2442) and active in the NPI registry since April 2006.

NPPES Registry Identity

NPI1821055278

Entity TypeIndividualFemale

Primary Taxonomy208000000X

Provider Legal NameDR. JOHANNA T MALLARECredential: MD

Location Address108 W TYLER AVEWest Memphis, AR 72301-4221

Mailing Address108 W Tyler AveWest Memphis, AR 72301-4221 · (870) 732-1191 · Fax (870) 732-4091

Phone(870) 732-1191

Fax(870) 732-4091

Sole ProprietorNo

Enumeration DateApril 28, 2006

Last NPPES UpdateOctober 8, 20202 updates tracked since enumeration

NPPES CertifiedOctober 8, 2020

✔ NPI 1821055278 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians

Taxonomy Code208000000X

License✔ Licensed in AR · E2442

Definition

A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

108 W TYLER AVE, West Memphis, AR 72301

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Other Identifiers 1

Medicaid142052001AR

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arkansas Health & Wellness, Ambetter from Home State Health, Ambetter from Louisiana Healthcare Connections and more.Insurance ›

Other Providers at the Same Location NPPES 8

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

AYESHA SAEED SHAH MD

Pediatrics