MEDICARE: DON PAYNE

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	171W00000X	Contractor

General Provider Information

NPI Number	:	1508281643
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DON PAYNE

Provider Business Mailing Address
First Line	:	3104 S PRESCOTT AVE
Second Line	:
City	:	BLUE SPRINGS
State	:	MO
Zip	:	64015-1125
Country	:	US
Telephone Number	:	816-220-1960
Fax Number	:	816-220-3130

Provider Business Practice Location Address
First Line	:	3104 S PRESCOTT AVE
Second Line	:
City	:	BLUE SPRINGS
State	:	MO
Zip	:	64015-1125
Country	:	US
Telephone Number	:	816-220-1960
Fax Number	:	816-220-3130

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

Provider Enumeration Date	:	02/26/2014
Last Update Date	:	02/26/2014

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Directions to “ DON PAYNE ” Practice Location

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