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General NPI Number Information
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NPI Number | 1275633307
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Entity Type | Organization
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Legal Business Name | JEP P. DALTON, M.D., P.C.
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Dates
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Enumeration Date | 09/25/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2055 E SOUTH BLVD SUITE 706
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City | MONTGOMERY
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State | AL
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Zip | 36116-2001
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Country | US
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Telephone | 334-288-2900
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Fax | 334-281-2637
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Provider Business Mailing Address
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Address Line | 2055 E SOUTH BLVD SUITE 706
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City | MONTGOMERY
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State | AL
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Zip | 36116-2001
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Country | US
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Telephone | 334-288-2900
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Fax | 334-281-2637
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JEP P DALTON
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Credential | M.D.
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Telephone | 334-288-2900
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | 7421
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License Number State | AL
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