Healthcare Provider Details

I. General information

NPI: 1932104528
Provider Name (Legal Business Name): JOHN C DALTON M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/20/2005
Last Update Date: 04/08/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 29TH AVE N STE 202
NASHVILLE TN
37203-1448
US

IV. Provider business mailing address

110 29TH AVE N STE 202
NASHVILLE TN
37203-1448
US

V. Phone/Fax

Practice location:
  • Phone: 615-327-7870
  • Fax: 615-327-5435
Mailing address:
  • Phone: 615-327-7870
  • Fax: 615-327-5435

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License Number017244
License Number StateTN
# 2
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number17244
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: