Provider Demographics
NPI:1255437778
Name:LAYTON, DONALD C (PHD)
Entity type:Individual
Prefix:
First Name:DONALD
Middle Name:C
Last Name:LAYTON
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
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Mailing Address - Street 1:8333 NAAB RD
Mailing Address - Street 2:SUITE 250
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46260-5924
Mailing Address - Country:US
Mailing Address - Phone:317-396-1300
Mailing Address - Fax:317-396-1346
Practice Address - Street 1:355 W 16TH ST
Practice Address - Street 2:SUITE 5100
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46202-2207
Practice Address - Country:US
Practice Address - Phone:317-396-1300
Practice Address - Fax:317-924-8472
Is Sole Proprietor?:No
Enumeration Date:2006-09-15
Last Update Date:2014-04-01
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IN20040047103G00000X
IN20040047A103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
INP01271614OtherRAILROAD MEDICARE
IN200884610Medicaid
IN210870003Medicare PIN