MEDICARE: DR. DAVID E PAYNE PSY.D.

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	103TC0700X	Clinical Psychologist	PS008654L	PA

General Provider Information

NPI Number	:	1437246048
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DAVID E PAYNE PSY.D.

Provider Business Mailing Address
First Line	:	473 LEXINGTON DR
Second Line	:
City	:	KING OF PRUSSIA
State	:	PA
Zip	:	19406-1561
Country	:	US
Telephone Number	:	610-337-0665
Fax Number	:

Provider Business Practice Location Address
First Line	:	1425 HORSHAM RD
Second Line	:
City	:	NORTH WALES
State	:	PA
Zip	:	19454-1320
Country	:	US
Telephone Number	:	215-371-3683
Fax Number	:	215-371-3039

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

Provider Enumeration Date	:	10/06/2006
Last Update Date	:	02/18/2015

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