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General NPI Number Information
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NPI Number | 1386750941
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Entity Type | Individual
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Provider Name | JO ANN T PAYNE OD
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Gender | Female
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Dates
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Enumeration Date | 08/23/2006
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Last Update Date | 08/26/2010
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Provider Practice Location Address
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Address Line | 4330 JOHNS CREEK PKWY SUITE 300
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City | SUWANEE
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State | GA
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Zip | 30024-6047
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Country | US
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Telephone | 770-232-7844
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Fax | 770-232-9455
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Provider Business Mailing Address
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Address Line | 4330 JOHNS CREEK PKWY SUITE 300
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City | SUWANEE
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State | GA
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Zip | 30024-6047
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Country | US
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Telephone | 770-232-7844
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Fax | 770-232-9455
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 001247
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License Number State | GA
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