Provider Demographics
NPI:1558333914
Name:DAYTON, PAUL (DPM)
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:
Last Name:DAYTON
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3720 N ANKENY BLVD STE 103
Mailing Address - Street 2:
Mailing Address - City:ANKENY
Mailing Address - State:IA
Mailing Address - Zip Code:50023-4619
Mailing Address - Country:US
Mailing Address - Phone:515-639-3775
Mailing Address - Fax:515-964-3012
Practice Address - Street 1:3720 N ANKENY BLVD STE 103
Practice Address - Street 2:
Practice Address - City:ANKENY
Practice Address - State:IA
Practice Address - Zip Code:50023-4619
Practice Address - Country:US
Practice Address - Phone:515-639-3775
Practice Address - Fax:515-964-3012
Is Sole Proprietor?:No
Enumeration Date:2006-02-01
Last Update Date:2020-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA00626213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IAU31760Medicare UPIN
IAI3336Medicare PIN