Provider Demographics
NPI:1609337518
Name:KIRKLAND, MALLORY ANNALOIS (DPM)
Entity type:Individual
Prefix:DR
First Name:MALLORY
Middle Name:ANNALOIS
Last Name:KIRKLAND
Suffix:
Gender:F
Credentials:DPM
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Mailing Address - Street 1:4101 CHARLOTTE AVE STE F185
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37209-4066
Mailing Address - Country:US
Mailing Address - Phone:256-273-7068
Mailing Address - Fax:833-450-6328
Practice Address - Street 1:1041 BALCH RD STE 320
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:AL
Practice Address - Zip Code:35758-8822
Practice Address - Country:US
Practice Address - Phone:256-273-7068
Practice Address - Fax:833-450-6328
Is Sole Proprietor?:No
Enumeration Date:2019-03-26
Last Update Date:2024-10-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AL368213E00000X, 213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
No213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist