Provider Demographics
NPI:1639121239
Name:PAYNE, DAYTON DENNIS JR (MD)
Entity Type:Individual
Prefix:
First Name:DAYTON
Middle Name:DENNIS
Last Name:PAYNE
Suffix:JR
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 1:225 18TH ST SE
Mailing Address - Street 2:
Mailing Address - City:HICKORY
Mailing Address - State:NC
Mailing Address - Zip Code:28602-1364
Mailing Address - Country:US
Mailing Address - Phone:828-322-9912
Mailing Address - Fax:828-322-4078
Practice Address - Street 1:225 18TH ST SE
Practice Address - Street 2:
Practice Address - City:HICKORY
Practice Address - State:NC
Practice Address - Zip Code:28602-1364
Practice Address - Country:US
Practice Address - Phone:828-322-9912
Practice Address - Fax:828-322-4078
Is Sole Proprietor?:No
Enumeration Date:2006-05-16
Last Update Date:2011-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC35459207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8966279Medicaid
NC8966279Medicaid
NCE36199Medicare UPIN