Waller Lisle Dalton, MD

Primary specialty

Gynecology PhysicianTaxonomy code 207VG0400X

License

18542 Issued in KY

Practice address

800 Rose Street
Lexington, KY 40536-0001

Phone

(859) 323-5345

NPI assigned

Jul 14, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Kentucky Medical Services Foundation, Inc

  • Internal Medicine Physician
  • Lexington, KY
  • NPI 1326091448
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1152835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1332115200000",
    "number": "1407872559",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "138 LEADER AVE",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405083215",
            "telephone_number": "859-257-7910",
            "fax_number": "859-257-7899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 ROSE STREET",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405360001",
            "telephone_number": "859-323-5345"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DALTON",
        "first_name": "WALLER",
        "middle_name": "LISLE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-14",
        "last_updated": "2012-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VG0400X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "KY",
            "license": "18542",
            "primary": true
        },
        {
            "code": "207VX0000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Obstetrics",
            "state": "KY",
            "license": "18542",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64185424",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Christine Marie Dalton, NURSE PRACTITIONER
• Christy Rene Dalton, OTR/L
• Morgan Dalton
• Paul David Dalton, MS, LPCC, CADC
• Stephanie Nicole Dalton, CSA
• Briejhonna Dame
• Douglas D. Damm, D.D.S.
• Rania Damra, CSW
• Janine Louise Damran, LPCC
• Donna S Damron, APRN

• Gynecology Physician in Lexington, KY
• Providers in Lexington, KY by specialty
• Gynecology Physician in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.