Individual
WILLARD T DALTON JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
8166 MAIN STREET, HOUMA, LA 70360
(985) 873-4141
(985) 851-4307
Mailing address
PO BOX 6037, HOUMA, LA 70361-6037
(985) 873-4235
(985) 851-4307
Taxonomy
Speciality
Code
Description
License number
State
207ZH0000X
Hematology (Pathology) Physician
MD08126R
LA
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
MD08126R
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1389650
—
LA
Enumeration date
02/08/2006
Last updated
06/07/2010
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