Provider Demographics
NPI:1306223110
Name:PAYDEN, RICHARD WILLIAM (MD)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:WILLIAM
Last Name:PAYDEN
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 1:3900 28TH AVENUE DR
Mailing Address - Street 2:
Mailing Address - City:MOLINE
Mailing Address - State:IL
Mailing Address - Zip Code:61265-5536
Mailing Address - Country:US
Mailing Address - Phone:309-421-6000
Mailing Address - Fax:
Practice Address - Street 1:3900 28TH AVENUE DR
Practice Address - Street 2:
Practice Address - City:MOLINE
Practice Address - State:IL
Practice Address - Zip Code:61265-5536
Practice Address - Country:US
Practice Address - Phone:309-421-6000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-04-30
Last Update Date:2023-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODR.0060938207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine