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NPI Code Detail

MEDICARE: DR. DAVID L DALTON M.D.

MEDICARE:  DR. DAVID L DALTON  M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207VG0400XGynecology PhysicianD8188TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
385V178OTHERTXBCBS

General Provider Information

NPI Number : 1205809043
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DAVID L DALTON M.D.
Provider Business Mailing Address
First Line : PO BOX 5500
Second Line :
City : TYLER
State : TX
Zip : 75712-5500
Country : US
Telephone Number : 903-324-6450
Fax Number :
Provider Business Practice Location Address
First Line : 214 E HOUSTON ST
Second Line :
City : TYLER
State : TX
Zip : 75702-8131
Country : US
Telephone Number : 903-535-9041
Fax Number : 903-533-0726
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/10/2006
Last Update Date : 04/03/2012

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Directions to “ DR. DAVID L DALTON M.D.” Practice Location

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