MEDICARE: DOUGLAS A. LAYTON DO

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
1	207Q00000X	Family Medicine Physician	02723	IA

Other Identifiers

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

General Provider Information

NPI Number	:	1831159193
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DOUGLAS A. LAYTON DO

Provider Business Mailing Address
First Line	:	1010 S 3RD ST
Second Line	:
City	:	POLK CITY
State	:	IA
Zip	:	50226-1130
Country	:	US
Telephone Number	:	515-984-6426
Fax Number	:

Provider Business Practice Location Address
First Line	:	1010 S 3RD ST
Second Line	:
City	:	POLK CITY
State	:	IA
Zip	:	50226-1130
Country	:	US
Telephone Number	:	515-984-6426
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/23/2006
Last Update Date	:	11/01/2019

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