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NPI Code Detail

MEDICARE: KATHERINE J PAYNE PA-C

MEDICARE: KATHERINE J PAYNE PA-C
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
1363AS0400XSurgical Physician Assistant1189OK
2363AM0700XMedical Physician Assistant1189OK

Other Identifiers

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

General Provider Information

NPI Number : 1710976071
Entity Type Code : Individual
Provider Name (Legal Business Name) : KATHERINE J PAYNE PA-C
Provider Business Mailing Address
First Line : 701 NE 36TH ST
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73105-7203
Country : US
Telephone Number : 405-631-0611
Fax Number : 405-631-0811
Provider Business Practice Location Address
First Line : 701 NE 36TH ST
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73105-7203
Country : US
Telephone Number : 405-631-0611
Fax Number : 405-631-0811
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/19/2005
Last Update Date : 06/13/2014

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Directions to “ KATHERINE J PAYNE PA-C” Practice Location

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