Provider Demographics
NPI:1235889866
Name:SALBADOR, DYLAN CLARK (DO)
Entity Type:Individual
Prefix:DR
First Name:DYLAN
Middle Name:CLARK
Last Name:SALBADOR
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:38237 MICHAEL ANTHONY CT
Mailing Address - Street 2:
Mailing Address - City:GONZALES
Mailing Address - State:LA
Mailing Address - Zip Code:70737-6084
Mailing Address - Country:US
Mailing Address - Phone:225-963-0355
Mailing Address - Fax:
Practice Address - Street 1:764 LAKELAND DR
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:MS
Practice Address - Zip Code:39216-4651
Practice Address - Country:US
Practice Address - Phone:601-984-6800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-26
Last Update Date:2022-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program