Ian Mall, is a
Clinical Nurse Specialist - Home Health based in Ooltewah, Tennessee. Ian Mall is licensed to practice in Tennessee (license number 20836) and his current practice location is
9981 Forrest Dr, Ooltewah, Tennessee. He can be reached at his office (for appointments etc.) via phone at
(423) 362-8192.
NPI number for Ian Mall is 1144689456 and his current mailing address is 9981 Forrest Dr, Ooltewah, Tennessee. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1144689456.
Provider's Profile
| Full Name | Ian Mall |
|---|
| Gender | Male |
|---|
| Speciality | Clinical Nurse Specialist - Home Health |
|---|
| Location | 9981 Forrest Dr, Ooltewah, Tennessee |
|---|
| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
|---|
NPI Data:
- NPI Number: 1144689456
- Provider Enumeration Date: 02/15/2016
- Last Update Date: 02/15/2016
Medical Identifiers
Medical identifiers for Ian Mall such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1144689456 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 364SH0200X | Clinical Nurse Specialist - Home Health | 20836 (Tennessee) | 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. Ian Mall 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 |
|---|
Ian Mall,
9981 Forrest Dr,
Ooltewah, TN 37363-8300
Ph: (423) 362-8192 | Ian Mall,
9981 Forrest Dr,
Ooltewah, TN 37363-8300
Ph: (423) 362-8192 |
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