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Individual

DR. JEP P. DALTON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
2055 E SOUTH BLVD, SUITE 706, MONTGOMERY, AL 36116-2001
(334) 288-2900
Mailing address
2055 E SOUTH BLVD, SUITE 706, MONTGOMERY, AL 36116-2001
(334) 288-2900

Taxonomy

Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
7421
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
51012779
BLUE CROSS BLUE SHIELD
AL
Enumeration date
08/28/2006
Last updated
07/08/2007
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