Individual provider Active NPI

Dalton Davis, PHARMD

  • Pharmacist
  • Laurel, MS
National Provider Identifier
1851264816
Registry record updated Oct 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
T-102070 Issued in MS
Practice address
419 N 16TH Ave
Laurel, MS 39440-3850
Phone
(601) 425-5808
NPI assigned
Sep 25, 2025
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 10, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X T-102070 MS Primary
Pharmacist 183500000X RPH035548 GA

Addresses

Primary practice location

419 N 16TH Ave
Laurel, MS 39440-3850

Mailing address

419 N 16TH Ave
Laurel, MS 39440-3850
Phone (601) 425-5808

Other practice location 1

804 Spring St
Waynesboro, MS 39367-2422
Phone (601) 735-2513

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
RPH035548GAMDPharmacist
T-102070MSMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1758758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760054400000",
    "number": "1851264816",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "419 N 16TH AVE",
            "city": "LAUREL",
            "state": "MS",
            "postal_code": "394403850",
            "telephone_number": "601-425-5808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "419 N 16TH AVE",
            "city": "LAUREL",
            "state": "MS",
            "postal_code": "394403850",
            "telephone_number": "601-425-5808"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "804 Spring St",
            "address_purpose": "LOCATION",
            "city": "Waynesboro",
            "state": "MS",
            "postal_code": "393672422",
            "country_code": "US",
            "telephone_number": "601-735-2513",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "DALTON",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-09-25",
        "last_updated": "2025-10-10",
        "certification_date": "2025-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MS",
            "license": "T-102070",
            "primary": true
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "GA",
            "license": "RPH035548",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Laurel, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2025; 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.