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General NPI Number Information
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NPI Number | 1033964051
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Entity Type | Individual
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Provider Name | JOSHUA THOMAS PAYNE MD
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Gender | Male
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Dates
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Enumeration Date | 04/22/2024
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Last Update Date | 04/22/2024
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Provider Practice Location Address
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Address Line | 4502 MEDICAL DR
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City | SAN ANTONIO
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State | TX
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Zip | 78229-4492
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Country | US
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Telephone | 210-567-4509
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Fax |
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Provider Business Mailing Address
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Address Line | 321 WIMBLEDON CHASE APT B
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City | CHESAPEAKE
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State | VA
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Zip | 23320-4964
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Country | US
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Telephone | 757-848-6955
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | BP10088554
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License Number State | TX
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