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NPI Code Detail

MEDICARE: DR. JOHN PAYNE MD

MEDICARE: DR. JOHN 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
1207R00000XInternal Medicine Physician17050MS

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2110239904OTHERMSMEDICARE RAILROAD

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 : 1760451991
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JOHN PAYNE MD
Provider Business Mailing Address
First Line : PO BOX 677957
Second Line :
City : DALLAS
State : TX
Zip : 75267-7957
Country : US
Telephone Number : 225-765-5727
Fax Number : 225-765-4278
Provider Business Practice Location Address
First Line : 969 LAKELAND DR
Second Line :
City : JACKSON
State : MS
Zip : 39216-4606
Country : US
Telephone Number : 601-200-4644
Fax Number : 601-200-4645
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/17/2006
Last Update Date : 08/05/2022

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Directions to “ DR. JOHN PAYNE MD” Practice Location

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