MEDICARE: DR. MARK L. KAYTON MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208600000X	Surgery Physician	ME103692	FL
2	208600000X	Surgery Physician	25MA09265400	NJ
3	2086S0120X	Pediatric Surgery Physician	ME103692	FL
4	2086S0120X	Pediatric Surgery Physician	25MA09265400	NJ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	17010	OTHER	FL	BLUE CROSS BLUE SHIELD
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1790760577
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARK L. KAYTON MD

Provider Business Mailing Address
First Line	:	19 DAVIS AVE FL 4
Second Line	:
City	:	NEPTUNE
State	:	NJ
Zip	:	07753-4488
Country	:	US
Telephone Number	:	732-935-0407
Fax Number	:	732-935-0757

Provider Business Practice Location Address
First Line	:	19 DAVIS AVE FL 4
Second Line	:
City	:	NEPTUNE
State	:	NJ
Zip	:	07753-4488
Country	:	US
Telephone Number	:	732-935-0407
Fax Number	:	732-935-0757

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/14/2005
Last Update Date	:	09/07/2022

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Directions to “ DR. MARK L. KAYTON MD” Practice Location

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