Individual
DANIEL A. DEIGHTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
233 N HOUSTON RD, SUITE 140-F, WARNER ROBINS, GA 31093-3074
(478) 293-1580
(478) 293-1583
Mailing address
PO BOX 7567, WARNER ROBINS, GA 31095-7567
(478) 293-1580
(478) 293-1583
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
040361
GA
208800000X
Urology Physician
Primary
040361
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000670612C
—
GA
Enumeration date
05/04/2006
Last updated
03/24/2010
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