Thomas Malott, PA is a
Physician Assistant based in Peru, Indiana. Thomas Malott is licensed to practice in Indiana (license number 10000716A) and his current practice location is
285 W 12th St, Ste 112, Peru, Indiana. He can be reached at his office (for appointments etc.) via phone at
(765) 475-2388.
NPI number for Thomas Malott is 1114982386 and his current mailing address is 285 W 12th St, Ste. 103, Peru, Indiana. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1114982386.
Provider's Profile
| Full Name | Thomas Malott |
|---|
| Gender | Male |
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| Speciality | Physician Assistant |
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| Location | 285 W 12th St, Peru, Indiana |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1114982386
- Provider Enumeration Date: 04/19/2006
- Last Update Date: 03/27/2012
Medical Identifiers
Medical identifiers for Thomas Malott such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1114982386 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 363A00000X | Physician Assistant | 10000716A (Indiana) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Thomas Malott is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Thomas Malott, PA
285 W 12th St, Ste. 103,
Peru, IN 46970-1653
Ph: (765) 475-2316 | Thomas Malott, PA
285 W 12th St, Ste 112,
Peru, IN 46970-1653
Ph: (765) 475-2388 |
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