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General NPI Number Information
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NPI Number | 1154823029
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Entity Type | Individual
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Provider Name | TAYLOR PAYNE
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Gender | Male
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Dates
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Enumeration Date | 03/06/2018
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Last Update Date | 06/24/2021
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Provider Practice Location Address
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Address Line | 1423 GADSDEN HWY STE 135
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City | BIRMINGHAM
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State | AL
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Zip | 35235-3154
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Country | US
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Telephone | 205-655-1921
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Fax |
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Provider Business Mailing Address
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Address Line | 2823 GREYSTONE COMMERCIAL BLVD
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City | HOOVER
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State | AL
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Zip | 35242-2660
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Country | US
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Telephone |
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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 | 2081S0010X
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Taxonomy Name | Sports Medicine (Physical Medicine & Rehabilitation) Physician
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License Number | 1636
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License Number State | AL
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PTH10354
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License Number State | AL
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