Healthcare Provider Details

I. General information

NPI: 1528553344
Provider Name (Legal Business Name): ALEX LAYNE DUTSON
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/25/2018
Last Update Date: 04/09/2026
Certification Date: 04/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1995 ERRECART BLVD
ELKO NV
89801-8346
US

IV. Provider business mailing address

1995 ERRECART BLVD STE 102
ELKO NV
89801-8336
US

V. Phone/Fax

Practice location:
  • Phone: 775-777-2061
  • Fax:
Mailing address:
  • Phone: 775-777-2061
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberDO2939
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: