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General NPI Number Information
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NPI Number | 1205886801
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Entity Type | Organization
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Legal Business Name | JARED DAYTON D O P C
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Dates
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Enumeration Date | 05/12/2006
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Last Update Date | 06/09/2022
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Provider Practice Location Address
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Address Line | 6840 E BROWN RD SUITE 101
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City | MESA
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State | AZ
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Zip | 85207-3759
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Country | US
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Telephone | 480-924-9797
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Fax | 480-588-6754
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Provider Business Mailing Address
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Address Line | 6840 E BROWN RD SUITE 101
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City | MESA
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State | AZ
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Zip | 85207-3759
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Country | US
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Telephone | 480-924-9797
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Fax | 480-588-6754
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Authorized Official
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Title or Position | PRESIDENT/CEO
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Name | DR. JARED L DAYTON
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Credential | DO
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Telephone | 480-924-9797
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 3678
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License Number State | AZ
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