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Contact Information

MARK A DALTON, OD
14 COMMUNITY PLZ
SULLIVAN, MO63080-1567
 Phone: 573-468-2020
 Fax: 636-556-9952
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Corneal and Contact Management

152WC0802X 41 Optometry
Indicates primary specialty

NPI Profile & details for MARK A DALTON · (Male)

NPI Number 1942291547
Status Active
Credentials OD (Doctor of Optometry)
Entity Individual
Enumeration date 11/02/2005
Last updated 08/07/2014 - About 12 years ago
Sole proprietor 1 Yes
Identifiers
  • MO License # 2002015836
  • MO Medicaid 315935700
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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