Dalton, Mark Alan
Dalton, Mark Alan is an sole proprietor health care provider with primary practice located at 14 Community Plz , Sullivan MO 63080-1567. He recently has only one registered license in Eye and Vision Services Providers / Corneal and Contact Management, which is considered as his primary health care specialty. Dalton, Mark Alan can be contacted via phone (573) 468-2020.Contact Information
Primary practice address
14 Community Plz
Sullivan MO 63080-1567
Phone: (573) 468-2020
Fax: (636) 556-9952
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Corneal and Contact Management | 152WC0802X | 2002015836 | Missouri |
Profile Details
| NPI number | 1942291547 |
|---|---|
| LBN Legal business name | Dalton, Mark Alan |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Nov 2nd, 2005 |
| Last updated | Aug 7th, 2014 - about 10 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1942291547 | NPPES |
| Missouri | MEDICAID | 315935700 |
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