Provider Demographics
NPI:1912517970
Name:LAYTON, DIYA BROOKE (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:DIYA
Middle Name:BROOKE
Last Name:LAYTON
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:DIYA
Other - Middle Name:BROOKE
Other - Last Name:HOWARD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1035 BALD MOUNTAIN CIR
Mailing Address - Street 2:
Mailing Address - City:GALLANT
Mailing Address - State:AL
Mailing Address - Zip Code:35972-1718
Mailing Address - Country:US
Mailing Address - Phone:850-549-6671
Mailing Address - Fax:
Practice Address - Street 1:3434 RAINBOW DR
Practice Address - Street 2:
Practice Address - City:RAINBOW CITY
Practice Address - State:AL
Practice Address - Zip Code:35906-6240
Practice Address - Country:US
Practice Address - Phone:256-413-1767
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-05
Last Update Date:2020-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL21509183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist