Basic Information
| Provider Information | |||||||||
| NPI: | 1083604482 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | LAYTON | ||||||||
| FirstName: | CALEB | ||||||||
| MiddleName: | RODNEY | ||||||||
| NamePrefix: | |||||||||
| NameSuffix: | JR. | ||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 100 E CARROLL ST | ||||||||
| Address2: | PRMC STATION #379 | ||||||||
| City: | SALISBURY | ||||||||
| State: | MD | ||||||||
| PostalCode: | 218015422 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4105437722 | ||||||||
| FaxNumber: | 9105437725 | ||||||||
| Practice Location | |||||||||
| Address1: | 100 E CARROLL ST | ||||||||
| Address2: | PRMC STATION #379 | ||||||||
| City: | SALISBURY | ||||||||
| State: | MD | ||||||||
| PostalCode: | 218015422 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4105437722 | ||||||||
| FaxNumber: | 9105437725 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/26/2005 | ||||||||
| LastUpdateDate: | 04/24/2014 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RP1001X | D0013222 | MD | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Pulmonary Disease |
ID Information
| ID | Type | State | Issuer | Description | 0000018301 | 01 | MEDICAL ASSISTANCE | OTHER | 0003 | 01 | BS NATIONAL CAPITAL AREA | OTHER | 1503877 | 01 | UNITED MINE WORKERS | OTHER | 36909 | 01 | MAMSI | OTHER | 290007326 | 01 | RAILROAD MEDICARE | OTHER | 41668302 | 01 | MD | BLUE CROSS/SHIELD | OTHER | 440832 | 01 | AETNA | OTHER | 509300604 | 01 | PHCS | OTHER | 040401200 | 05 | MD | MEDICAID | 6063888 | 01 | VA | MEDICAL ASSISTANCE | OTHER | 32051 | 01 | PRIORITY PARTNERS | OTHER |