Healthcare Provider Details
I. General information
NPI: 1659755320
Provider Name (Legal Business Name): DAVID A DALTON DO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 07/13/2015
Last Update Date: 02/19/2025
Certification Date: 02/18/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
137 N MAIN ST
CEDAR CITY UT
84720-2650
US
IV. Provider business mailing address
137 N MAIN ST
CEDAR CITY UT
84720-2650
US
V. Phone/Fax
- Phone: 435-708-1955
- Fax: 816-718-3751
- Phone: 435-708-1955
- Fax: 816-718-3751
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 204D00000X |
| Taxonomy | Neuromusculoskeletal Medicine & OMM Physician |
| License Number | 11377208-1204 |
| License Number State | UT |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | 11377208-1204 |
| License Number State | UT |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 204D00000X |
| Taxonomy | Neuromusculoskeletal Medicine & OMM Physician |
| License Number | DO2594 |
| License Number State | NV |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | 011122 |
| License Number State | AZ |
| # 5 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | 20A23406 |
| License Number State | CA |
| # 6 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | DO2594 |
| License Number State | NV |
| # 7 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | 2015020391 |
| License Number State | MO |
VII. Legacy identifiers
For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: