Provider Demographics
NPI:1043296775
Name:PAYNE, DARRICK (MD)
Entity Type:Individual
Prefix:DR
First Name:DARRICK
Middle Name:
Last Name:PAYNE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11945 MEADE CT
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:CO
Mailing Address - Zip Code:80031-5152
Mailing Address - Country:US
Mailing Address - Phone:303-570-0270
Mailing Address - Fax:
Practice Address - Street 1:780 KIPLING ST STE 200
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80215-8009
Practice Address - Country:US
Practice Address - Phone:720-408-5220
Practice Address - Fax:303-422-9474
Is Sole Proprietor?:No
Enumeration Date:2005-12-15
Last Update Date:2021-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO38954207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO44620365Medicaid
CO44620365Medicaid