Individual
BRIAN GALEN ANDREW DALTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D,
Contact information
Practice address
655 W 8TH ST, JACKSONVILLE, FL 32209-6511
(904) 383-1015
(904) 244-3870
Mailing address
11945 SAN JOSE BLVD, STE 300, JACKSONVILLE, FL 32223-1627
(904) 396-1725
(904) 396-4893
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
35.122372
OH
208600000X
Surgery Physician
LL30950
SC
208600000X
Surgery Physician
MD454268
PA
208600000X
Surgery Physician
Primary
ME126414
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
57.022483
TRAINING CERTIFICATE
OH
01
—
LL30950
SOUTH CAROLINA BOARD OF MEDICAL EXAMINER'S
SC
01
—
MD454268
PENNSYLVANIA MEDICAL BOARD
PA
01
—
ME126414
FLORIDA BOARD OF MEDICINE
FL
Enumeration date
06/27/2008
Last updated
08/27/2021
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