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General NPI Number Information
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NPI Number | 1568826253
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Entity Type | Individual
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Provider Name | MICHELLE PAYNE M.D.
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Gender | Female
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Dates
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Enumeration Date | 04/08/2016
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Last Update Date | 07/25/2019
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Provider Practice Location Address
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Address Line | 2959 SHARPSBURG MCCULLUM RD
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City | NEWNAN
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State | GA
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Zip | 30265-2297
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Country | US
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Telephone | 770-502-2020
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Fax |
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Provider Business Mailing Address
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Address Line | 2727 PACES FERRY RD SE STE 1-1100
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City | ATLANTA
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State | GA
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Zip | 30339-6151
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Country | US
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Telephone | 470-271-3418
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 082823
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License Number State | GA
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