Dayton, Mark A

Dayton, Mark A is an individual health care provider with primary practice located at 601 W 2Nd St , Bloomington IN 47403-2317. He recently has only one registered license in Allopathic & Osteopathic Physicians / Hematology, which is considered as his primary health care specialty. Dayton, Mark A can be contacted via phone (812) 331-3405.

Contact Information

Primary practice address
601 W 2Nd St Bloomington IN 47403-2317
Fax: (812) 355-6538
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Hematology 207RH0000X 01033747A Indiana

Profile Details

NPI number 1790780625
LBN Legal business name Dayton, Mark A
Credentials MD, PHD
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 16th, 2005
Last updated May 7th, 2019 - about 7 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1790780625 NPPES
Indiana MEDICAID 200482850

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