Provider Demographics
NPI:1962601831
Name:LAYTON, THOMAS LAWRENCE (PHD)
Entity type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:LAWRENCE
Last Name:LAYTON
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:MRS
Other - First Name:THOMAS
Other - Middle Name:L
Other - Last Name:LAYTON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:100 MEREDITH DR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27713-5237
Mailing Address - Country:US
Mailing Address - Phone:919-484-0012
Mailing Address - Fax:919-484-0081
Practice Address - Street 1:T & T COMMUNICATION
Practice Address - Street 2:100 MEREDITH DRIVE, SUITE 100
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27713
Practice Address - Country:US
Practice Address - Phone:919-484-0012
Practice Address - Fax:919-484-0081
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-12
Last Update Date:2007-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC794235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC562174128OtherTAX ID
NC7210649Medicaid