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Individual

DOUGLAS DAVID DALTON II

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
603 CAMPUS DR, SUITE 100, ABINGDON, VA 24210-9700
(276) 739-8010
(276) 628-1410
Mailing address
603 CAMPUS DR, SUITE 100, ABINGDON, VA 24210-9700
(276) 739-8010
(276) 628-1410

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0110001236
VI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1255300109
VA
05
Q008299
TN
Enumeration date
03/14/2006
Last updated
02/01/2017
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