Provider Demographics
NPI:1851946131
Name:BARTON, DALTON THOMAS (PA-C)
Entity type:Individual
Prefix:
First Name:DALTON
Middle Name:THOMAS
Last Name:BARTON
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1055 N 500 W
Mailing Address - Street 2:ATT CREDENTIALING
Mailing Address - City:PROVO
Mailing Address - State:UT
Mailing Address - Zip Code:84604
Mailing Address - Country:US
Mailing Address - Phone:801-354-8225
Mailing Address - Fax:801-418-0941
Practice Address - Street 1:770 S HIGHWAY 99
Practice Address - Street 2:
Practice Address - City:FILLMORE
Practice Address - State:UT
Practice Address - Zip Code:84631-5033
Practice Address - Country:US
Practice Address - Phone:435-253-8000
Practice Address - Fax:801-655-5213
Is Sole Proprietor?:No
Enumeration Date:2019-08-05
Last Update Date:2024-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
363AM0700X
UT13860465-1206363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical