Individual
JIM E DAULTON JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1485 N TURQUOISE DR STE 200, FLAGSTAFF, AZ 86001-2000
(928) 774-7757
(928) 774-7767
Mailing address
18444 N 25TH AVE STE 310, PHOENIX, AZ 85023-1266
(866) 974-2673
(866) 939-2673
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
8578
AZ
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
08/26/2019
Last updated
08/25/2021
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