Provider Demographics
NPI:1184605461
Name:DAYTON-JONES, CONWORTH L (MD)
Entity type:Individual
Prefix:DR
First Name:CONWORTH
Middle Name:L
Last Name:DAYTON-JONES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 PINE BLUFF RD
Mailing Address - Street 2:SUITE 25
Mailing Address - City:SALISBURY
Mailing Address - State:MD
Mailing Address - Zip Code:21801-7163
Mailing Address - Country:US
Mailing Address - Phone:410-742-7246
Mailing Address - Fax:410-742-0777
Practice Address - Street 1:264 TILGHMAN RD
Practice Address - Street 2:
Practice Address - City:SALISBURY
Practice Address - State:MD
Practice Address - Zip Code:21804-1921
Practice Address - Country:US
Practice Address - Phone:410-742-7246
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-11-14
Last Update Date:2018-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0041055207LP2900X, 207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD755961500Medicaid
P00702373OtherRAILROAD MEDICARE
MD755961500Medicaid
P00702373OtherRAILROAD MEDICARE