Provider Demographics
NPI:1568450542
Name:PAYTON, HARRY H (DO)
Entity Type:Individual
Prefix:
First Name:HARRY
Middle Name:H
Last Name:PAYTON
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:920 RUSH DR
Mailing Address - Street 2:
Mailing Address - City:SALIDA
Mailing Address - State:CO
Mailing Address - Zip Code:81201-9669
Mailing Address - Country:US
Mailing Address - Phone:719-539-9300
Mailing Address - Fax:719-539-9333
Practice Address - Street 1:920 RUSH DR
Practice Address - Street 2:
Practice Address - City:SALIDA
Practice Address - State:CO
Practice Address - Zip Code:81201-9669
Practice Address - Country:US
Practice Address - Phone:719-539-9300
Practice Address - Fax:719-539-9333
Is Sole Proprietor?:No
Enumeration Date:2005-10-12
Last Update Date:2017-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODR.0048772207YX0905X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207YX0905XAllopathic & Osteopathic PhysiciansOtolaryngologyOtolaryngology/Facial Plastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MEE16975OtherHARVARD PILGRIM
MEAX5099OtherMEDICARE PTAN GRP 152556
MEHX1692OtherMEDICARE PTAN GRP MM8648
ME002298OtherANTHEM
ME1044199OtherAETNA
ME002298OtherANTHEM
ME1044199OtherAETNA
MEAX5099OtherMEDICARE PTAN GRP 152556
MEE16975OtherHARVARD PILGRIM
MEE16975OtherHARVARD PILGRIM