Healthcare Provider Details

I. General information

NPI: 1639001845
Provider Name (Legal Business Name): PEYTON BELTON OTD, OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/01/2026
Last Update Date: 06/01/2026
Certification Date: 06/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12305 HIGHWAY 57
VANCLEAVE MS
39565-9501
US

IV. Provider business mailing address

1417 DOROTHY ST
OCEAN SPRINGS MS
39564-8559
US

V. Phone/Fax

Practice location:
  • Phone: 228-238-0206
  • Fax:
Mailing address:
  • Phone: 228-219-4703
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOT-4245
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: