MEDICARE: PAYTON HUMPHREY 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
1	363AS0400X	Surgical Physician Assistant

General Provider Information

NPI Number	:	1942131990
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PAYTON HUMPHREY PA-C

Provider Business Mailing Address
First Line	:	1900 LAFAYETTE RD
Second Line	:
City	:	PORTSMOUTH
State	:	NH
Zip	:	03801-5679
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1900 LAFAYETTE RD
Second Line	:
City	:	PORTSMOUTH
State	:	NH
Zip	:	03801-5679
Country	:	US
Telephone Number	:	603-431-1121
Fax Number	:

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

Provider Enumeration Date	:	05/28/2026
Last Update Date	:	05/28/2026

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Directions to “ PAYTON HUMPHREY PA-C” Practice Location

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