Basic Information
| Provider Information | |||||||||
| NPI: | 1225529340 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | DAYTON | ||||||||
| FirstName: | ALEXANDER | ||||||||
| MiddleName: | CALVIN | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 64 ADDISON RD APT 210 | ||||||||
| Address2: | |||||||||
| City: | GLASTONBURY | ||||||||
| State: | CT | ||||||||
| PostalCode: | 060331695 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8606597923 | ||||||||
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| Practice Location | |||||||||
| Address1: | 593 EDDY ST | ||||||||
| Address2: | |||||||||
| City: | PROVIDENCE | ||||||||
| State: | RI | ||||||||
| PostalCode: | 029034923 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4014444247 | ||||||||
| FaxNumber: | 4014446662 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/24/2018 | ||||||||
| LastUpdateDate: | 06/19/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 06/19/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207P00000X | LP04257 | RI | Y | Allopathic & Osteopathic Physicians | Emergency Medicine | 207P00000X | 70008 | CT | N | Allopathic & Osteopathic Physicians | Emergency Medicine |
No ID Information.