Provider Demographics
NPI:1790760577
Name:KAYTON, MARK L (MD)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:L
Last Name:KAYTON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:19 DAVIS AVE FL 4
Mailing Address - Street 2:
Mailing Address - City:NEPTUNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07753-4488
Mailing Address - Country:US
Mailing Address - Phone:732-935-0407
Mailing Address - Fax:732-935-0757
Practice Address - Street 1:19 DAVIS AVE FL 4
Practice Address - Street 2:
Practice Address - City:NEPTUNE
Practice Address - State:NJ
Practice Address - Zip Code:07753-4488
Practice Address - Country:US
Practice Address - Phone:732-935-0407
Practice Address - Fax:732-935-0757
Is Sole Proprietor?:No
Enumeration Date:2005-12-14
Last Update Date:2022-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME103692208600000X, 2086S0120X
NJ25MA09265400208600000X, 2086S0120X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0120XAllopathic & Osteopathic PhysiciansSurgeryPediatric Surgery
No208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL17010OtherBLUE CROSS BLUE SHIELD
FL000659400Medicaid
NJ363731Medicaid
FL17010OtherBLUE CROSS BLUE SHIELD