Provider Demographics
NPI:1598838153
Name:PAYNE, JOHN H (DMD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:H
Last Name:PAYNE
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1701 ST ELIZABETH SQ
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36117-4390
Mailing Address - Country:US
Mailing Address - Phone:334-277-6690
Mailing Address - Fax:334-277-6721
Practice Address - Street 1:2600 BELL RD
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36117-4375
Practice Address - Country:US
Practice Address - Phone:334-277-6690
Practice Address - Fax:334-277-6690
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-15
Last Update Date:2015-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL48691223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL515-23254OtherBLUE CROSS BLUE SHIELD
AL510-60720OtherBLUE CROSS BLUE SHILED
AL770948OtherUNITED CONCORDIA
AL510-60720OtherBLUE CROSS BLUE SHILED