Provider Demographics
NPI:1043592652
Name:FONG KONG-PAYTON, FELICIA A (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:FELICIA
Middle Name:A
Last Name:FONG KONG-PAYTON
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1458 GOVERNORS RIDGE CT
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37064-8933
Mailing Address - Country:US
Mailing Address - Phone:407-579-5554
Mailing Address - Fax:
Practice Address - Street 1:4870 PORT ROYAL RD
Practice Address - Street 2:
Practice Address - City:SPRING HILL
Practice Address - State:TN
Practice Address - Zip Code:37174
Practice Address - Country:US
Practice Address - Phone:931-487-9022
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-09
Last Update Date:2019-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS41427183500000X
TN33549183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist