Provider Demographics
NPI:1508281643
Name:PAYNE, DON
Entity Type:Individual
Prefix:
First Name:DON
Middle Name:
Last Name:PAYNE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3104 S PRESCOTT AVE
Mailing Address - Street 2:
Mailing Address - City:BLUE SPRINGS
Mailing Address - State:MO
Mailing Address - Zip Code:64015-1125
Mailing Address - Country:US
Mailing Address - Phone:816-220-1960
Mailing Address - Fax:816-220-3130
Practice Address - Street 1:3104 S PRESCOTT AVE
Practice Address - Street 2:
Practice Address - City:BLUE SPRINGS
Practice Address - State:MO
Practice Address - Zip Code:64015-1125
Practice Address - Country:US
Practice Address - Phone:816-220-1960
Practice Address - Fax:816-220-3130
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-26
Last Update Date:2014-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor