Dalton, Waller Lisle

Dalton, Waller Lisle is an individual health care provider with primary practice located at 800 Rose Street , Lexington KY 40536-0001. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Gynecology, Allopathic & Osteopathic Physicians / Obstetrics. Allopathic & Osteopathic Physicians / Gynecology is his primary health care specialty. Dalton, Waller Lisle can be contacted via phone (859) 323-5345.

Contact Information

Primary practice address
800 Rose Street Lexington KY 40536-0001
Phone: (859) 323-5345
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Gynecology 207VG0400X 18542 Kentucky
Allopathic & Osteopathic Physicians / Obstetrics 207VX0000X 18542 Kentucky

Profile Details

NPI number 1407872559
LBN Legal business name Dalton, Waller Lisle
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 14th, 2006
Last updated Mar 19th, 2012 - about 13 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1407872559 NPPES
Kentucky MEDICAID 64185424

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