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NPI Code Detail

MEDICARE: MAI LEE PAYNE OT

MEDICARE: MAI LEE PAYNE OT
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
1225X00000XOccupational TherapistOT003214GA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
210037594OTHERGAAMERIGROUP

General Provider Information

NPI Number : 1114923208
Entity Type Code : Individual
Provider Name (Legal Business Name) : MAI LEE PAYNE OT
Provider Business Mailing Address
First Line : 365 S INDUSTRIAL BLVD
Second Line :
City : CALHOUN
State : GA
Zip : 30701-3075
Country : US
Telephone Number : 706-624-3000
Fax Number : 706-624-3001
Provider Business Practice Location Address
First Line : 365 S INDUSTRIAL BLVD
Second Line :
City : CALHOUN
State : GA
Zip : 30701-3075
Country : US
Telephone Number : 706-624-3000
Fax Number : 706-624-3001
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/22/2005
Last Update Date : 10/22/2015

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Directions to “ MAI LEE PAYNE OT” Practice Location

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