Provider Demographics
NPI:1275615254
Name:PAYNE, LILLIAN MARLENE (MD)
Entity Type:Individual
Prefix:MRS
First Name:LILLIAN
Middle Name:MARLENE
Last Name:PAYNE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:6458 MADISON CT
Mailing Address - Street 2:
Mailing Address - City:MCLEAN
Mailing Address - State:VA
Mailing Address - Zip Code:22101-4137
Mailing Address - Country:US
Mailing Address - Phone:703-821-1018
Mailing Address - Fax:703-848-1755
Practice Address - Street 1:1314 VINCENT PL
Practice Address - Street 2:
Practice Address - City:MCLEAN
Practice Address - State:VA
Practice Address - Zip Code:22101
Practice Address - Country:US
Practice Address - Phone:703-821-1018
Practice Address - Fax:703-848-1755
Is Sole Proprietor?:No
Enumeration Date:2006-10-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VAVA01010278502084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry