Healthcare Provider Details

I. General information

NPI: 1043746589
Provider Name (Legal Business Name): DANIEL RENE LAYON MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/03/2017
Last Update Date: 09/14/2023
Certification Date: 09/12/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11958 W BROAD ST FL 5
HENRICO VA
23233-1007
US

IV. Provider business mailing address

PO BOX 780125
PHILADELPHIA PA
19178-0125
US

V. Phone/Fax

Practice location:
  • Phone: 804-364-6557
  • Fax: 804-828-4762
Mailing address:
  • Phone: 804-922-4844
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number0101278609
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: