Basic Information
| Provider Information | |||||||||
| NPI: | 1184687121 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | LAYTON | ||||||||
| FirstName: | DELMAR | ||||||||
| MiddleName: | KENT | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 64568 | ||||||||
| Address2: | |||||||||
| City: | PHOENIX | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 850824568 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6028396968 | ||||||||
| FaxNumber: | 6028394144 | ||||||||
| Practice Location | |||||||||
| Address1: | 2050 W SOUTHERN AVE | ||||||||
| Address2: | |||||||||
| City: | APACHE JUNCTION | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 851207305 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6028396968 | ||||||||
| FaxNumber: | 6028394144 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/10/2006 | ||||||||
| LastUpdateDate: | 12/04/2015 | ||||||||
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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 | 207P00000X | 12279 | AZ | Y | Allopathic & Osteopathic Physicians | Emergency Medicine | 207PE0004X | 12279 | AZ | N | Allopathic & Osteopathic Physicians | Emergency Medicine | Emergency Medical Services | 207PE0005X | 12279 | AZ | N | Allopathic & Osteopathic Physicians | Emergency Medicine | Undersea and Hyperbaric Medicine |
No ID Information.