Provider Demographics
NPI:1336326024
Name:PAYNE, MARLIN DALE JR (PA-C)
Entity Type:Individual
Prefix:MR
First Name:MARLIN
Middle Name:DALE
Last Name:PAYNE
Suffix:JR
Gender:M
Credentials:PA-C
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Mailing Address - Street 1:MITCHELL COUNTY HOSPITAL DISTRICT
Mailing Address - Street 2:997 WEST INTERSTATE 20
Mailing Address - City:COLORADO CITY
Mailing Address - State:TX
Mailing Address - Zip Code:79512
Mailing Address - Country:US
Mailing Address - Phone:325-728-3431
Mailing Address - Fax:325-728-9452
Practice Address - Street 1:MITCHELL COUNTY HOSPITAL DISTRICT
Practice Address - Street 2:997 WEST INTERSTATE 20
Practice Address - City:COLORADO CITY
Practice Address - State:TX
Practice Address - Zip Code:79512
Practice Address - Country:US
Practice Address - Phone:325-728-3431
Practice Address - Fax:325-728-9452
Is Sole Proprietor?:No
Enumeration Date:2008-01-25
Last Update Date:2024-03-29
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Provider Licenses
StateLicense IDTaxonomies
TXPA07221363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical