Provider Demographics
NPI:1912569104
Name:STATON, DONALD TAYLOR SMITH (DPT)
Entity Type:Individual
Prefix:DR
First Name:DONALD
Middle Name:TAYLOR SMITH
Last Name:STATON
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:49066 HEIGHTS LN
Mailing Address - Street 2:
Mailing Address - City:KENAI
Mailing Address - State:AK
Mailing Address - Zip Code:99611-6112
Mailing Address - Country:US
Mailing Address - Phone:907-290-9973
Mailing Address - Fax:
Practice Address - Street 1:43900 KENAI SPUR HWY UNIT C
Practice Address - Street 2:
Practice Address - City:KENAI
Practice Address - State:AK
Practice Address - Zip Code:99611-9708
Practice Address - Country:US
Practice Address - Phone:907-283-3340
Practice Address - Fax:907-283-3349
Is Sole Proprietor?:No
Enumeration Date:2019-07-08
Last Update Date:2021-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK111973225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist