Tamala Rochelle Mallett Moore, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

26755 Issued in OK

Practice address

3739 Legacy St
Weatherford, OK 73096-9746

Phone

(580) 772-2400

Fax

(580) 772-2408

NPI assigned

Oct 8, 2008

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Dr. Tamala Rochelle Mallett Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1223424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1296432000000",
    "number": "1609027622",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3739 LEGACY ST",
            "city": "WEATHERFORD",
            "state": "OK",
            "postal_code": "730969746",
            "telephone_number": "580-772-2400",
            "fax_number": "580-772-2408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3739 LEGACY ST",
            "city": "WEATHERFORD",
            "state": "OK",
            "postal_code": "730969746",
            "telephone_number": "580-772-2400",
            "fax_number": "580-772-2408"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALLETT MOORE",
        "first_name": "TAMALA",
        "middle_name": "ROCHELLE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-10-08",
        "last_updated": "2011-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OK",
            "license": "26755",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200224110A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TAMALA",
            "last_name": "MALLETT",
            "middle_name": "ROCHELLE",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jeff A Lunday, D.D.S.
• Dusten Christopher Lynn
• Kirsti McKinzi Lynn, APRN-CNP
• Cassie Mahan, LPC
• Kris Mahlock, MS, ATC, LAT
• Morgan Mangels
• Marshall Huser Family Medicine PLLC
• Amy Martin, LPC
• Ashly Martin
• Sheila Antoinette Martin, BA

• Family Medicine Physician in Weatherford, OK
• Providers in Weatherford, OK by specialty
• Family Medicine Physician in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.