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General NPI Number Information
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NPI Number | 1306669239
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Entity Type | Individual
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Provider Name | KAYTON WELDON
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Gender | Female
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Dates
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Enumeration Date | 11/07/2024
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Last Update Date | 11/12/2024
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Provider Practice Location Address
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Address Line | 80 HERREN HILL RD STE C
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City | TALLASSEE
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State | AL
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Zip | 36078-1264
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Country | US
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Telephone | 334-640-0300
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Fax | 205-618-9706
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Provider Business Mailing Address
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Address Line | 1830 MONTCLAIR RD STE A
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City | IRONDALE
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State | AL
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Zip | 35210-2645
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Country | US
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Telephone | 205-775-0300
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 175T00000X
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Taxonomy Name | Peer Specialist
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License Number |
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License Number State |
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