Provider Demographics
NPI:1356075261
Name:LAYTON, GORDON MITCHELL (PA-C)
Entity type:Individual
Prefix:
First Name:GORDON
Middle Name:MITCHELL
Last Name:LAYTON
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:15441 US HIGHWAY 17 STE 501
Mailing Address - Street 2:
Mailing Address - City:HAMPSTEAD
Mailing Address - State:NC
Mailing Address - Zip Code:28443-0016
Mailing Address - Country:US
Mailing Address - Phone:910-685-7307
Mailing Address - Fax:910-685-7284
Practice Address - Street 1:15441 US HIGHWAY 17 STE 501
Practice Address - Street 2:
Practice Address - City:HAMPSTEAD
Practice Address - State:NC
Practice Address - Zip Code:28443-0016
Practice Address - Country:US
Practice Address - Phone:910-685-7307
Practice Address - Fax:910-685-7284
Is Sole Proprietor?:No
Enumeration Date:2022-07-15
Last Update Date:2024-01-17
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program