Provider Demographics
NPI:1376656199
Name:DALTON, ROBERT A (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:A
Last Name:DALTON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1600 SW ARCHER RD
Mailing Address - Street 2:BOX 100371
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32610-0327
Mailing Address - Country:US
Mailing Address - Phone:352-265-0301
Mailing Address - Fax:352-265-0627
Practice Address - Street 1:1600 SW ARCHER RD
Practice Address - Street 2:BOX 100371
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32610-0327
Practice Address - Country:US
Practice Address - Phone:352-265-0301
Practice Address - Fax:352-265-0627
Is Sole Proprietor?:No
Enumeration Date:2006-08-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME88211207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
18007ZMedicare ID - Type Unspecified
I46525Medicare UPIN