MEDICARE: MR. ERIC ALAN PAYNE MD

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
1	207R00000X	Internal Medicine Physician	MD11643R	LA
2	207R00000X	Internal Medicine Physician	11643R	LA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	G6438	OTHER	LA	BLUECROSS BLUESHIELD

General Provider Information

NPI Number	:	1356306864
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. ERIC ALAN PAYNE MD

Provider Business Mailing Address
First Line	:	38177 HIGHWAY 1055
Second Line	:
City	:	MOUNT HERMON
State	:	LA
Zip	:	70450-7023
Country	:	US
Telephone Number	:	985-322-2073
Fax Number	:	985-322-2076

Provider Business Practice Location Address
First Line	:	2020 WASHINGTON ST
Second Line	:
City	:	FRANKLINTON
State	:	LA
Zip	:	70438-2533
Country	:	US
Telephone Number	:	985-322-2073
Fax Number	:	985-322-2076

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/18/2006
Last Update Date	:	04/23/2024

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Directions to “ MR. ERIC ALAN PAYNE MD” Practice Location

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