Provider Demographics
NPI:1689557076
Name:HALE, DRAYTON ANSTEY (IDC)
Entity type:Individual
Prefix:
First Name:DRAYTON
Middle Name:ANSTEY
Last Name:HALE
Suffix:
Gender:M
Credentials:IDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:96 LOCUST CIR
Mailing Address - Street 2:
Mailing Address - City:GROTON
Mailing Address - State:CT
Mailing Address - Zip Code:06340-3024
Mailing Address - Country:US
Mailing Address - Phone:850-368-9561
Mailing Address - Fax:
Practice Address - Street 1:96 LOCUST CIR
Practice Address - Street 2:
Practice Address - City:GROTON
Practice Address - State:CT
Practice Address - Zip Code:06340-3024
Practice Address - Country:US
Practice Address - Phone:850-368-9561
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-31
Last Update Date:2025-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1710I1002XOther Service ProvidersMilitary Health Care ProviderIndependent Duty Corpsman