| Dr Randall Elliott Dalton, MD | |
|
110 Hardin Lane, Suite 10, Somerset, KY 42503-3818 | |
| (606) 451-3890 | |
| (606) 451-3896 |
| Full Name | Dr Randall Elliott Dalton |
|---|---|
| Gender | Male |
| Speciality | Otolaryngology |
| Location | 110 Hardin Lane, Somerset, Kentucky |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336155944 | NPI | - | NPPES |
| 2445705 | Medicaid | OH | |
| 35083245 | Other | LICENSE # |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Y00000X | Otolaryngology | 43128 (Kentucky) | Primary |
| Entity Name | Lake Cumberland Regional Hospital Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1861078685 PECOS PAC ID: 7214909456 Enrollment ID: O20040809001229 |
| Entity Name | Lake Cumberland Physician Practices Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1811356892 PECOS PAC ID: 2567510464 Enrollment ID: O20090504000210 |
| Entity Name | Baptist Health Medical Group Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1922401611 PECOS PAC ID: 5597867184 Enrollment ID: O20150219000942 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Randall Elliott Dalton, MD 110 Hardin Ln, Suite 10, Somerset, KY 42503-3818 Ph: (606) 451-3890 | Dr Randall Elliott Dalton, MD 110 Hardin Lane, Suite 10, Somerset, KY 42503-3818 Ph: (606) 451-3890 |
Travis Hamilton Denna, MD Otolaryngology Medicare: Accepting Medicare Assignments Practice Location: 350 Hospital Way, Somerset, KY 42503 Phone: 606-451-3890 Fax: 606-451-3896 | |
Mr. Kevin Thomas Kavanagh, MD Otolaryngology Medicare: Not Enrolled in Medicare Practice Location: 402 Bogle St, Ste 310, Somerset, KY 42503 Phone: 606-679-7426 Fax: 606-679-7745 |