MEDICARE: DR. MERCEDES V. PAYNE M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	9801436	NC
2	207Q00000X	Family Medicine Physician	0101233065	VA
3	207Q00000X	Family Medicine Physician	48882	TN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1225021306
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MERCEDES V. PAYNE M.D.

Provider Business Mailing Address
First Line	:	8850 RHEA COUNTY HWY STE 12
Second Line	:
City	:	DAYTON
State	:	TN
Zip	:	37321-7932
Country	:	US
Telephone Number	:	423-775-1160
Fax Number	:	423-775-1047

Provider Business Practice Location Address
First Line	:	22576 RHEA COUNTY HWY
Second Line	:	STE. 1, 2 & 3
City	:	SPRING CITY
State	:	TN
Zip	:	37381-5393
Country	:	US
Telephone Number	:	423-365-4486
Fax Number	:	423-822-5464

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/24/2005
Last Update Date	:	02/09/2021

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Directions to “ DR. MERCEDES V. PAYNE M.D.” Practice Location

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