Provider Demographics
NPI:1548266729
Name:MERITHEW, LAYTON WILLIAM (DC)
Entity type:Individual
Prefix:DR
First Name:LAYTON
Middle Name:WILLIAM
Last Name:MERITHEW
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6091 GEORGE WASHINGTON MEMORIAL HWY
Mailing Address - Street 2:
Mailing Address - City:GLOUCESTER
Mailing Address - State:VA
Mailing Address - Zip Code:23061-3750
Mailing Address - Country:US
Mailing Address - Phone:804-693-0093
Mailing Address - Fax:804-693-6311
Practice Address - Street 1:6091 GEORGE WASHINGTON MEMORIAL HWY
Practice Address - Street 2:
Practice Address - City:GLOUCESTER
Practice Address - State:VA
Practice Address - Zip Code:23061-3750
Practice Address - Country:US
Practice Address - Phone:804-693-0093
Practice Address - Fax:804-693-6311
Is Sole Proprietor?:No
Enumeration Date:2005-06-22
Last Update Date:2010-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104000677111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA051286OtherANTHEM
VA67621OtherCIGNA
VA460091OtherANTHEM HEALTHKEEPERS
VA89-1459-1Medicaid
VA350001255Medicare PIN
VA051286OtherANTHEM