Provider Demographics
NPI:1700869351
Name:PAYNE, WILLIAM SPENCER (PHD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:SPENCER
Last Name:PAYNE
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5040 BOB BILLINGS PKWY
Mailing Address - Street 2:STE D2
Mailing Address - City:LAWRENCE
Mailing Address - State:KS
Mailing Address - Zip Code:66049-3873
Mailing Address - Country:US
Mailing Address - Phone:785-312-0474
Mailing Address - Fax:888-607-5875
Practice Address - Street 1:5040 BOB BILLINGS PKWY
Practice Address - Street 2:STE D2
Practice Address - City:LAWRENCE
Practice Address - State:KS
Practice Address - Zip Code:66049-3873
Practice Address - Country:US
Practice Address - Phone:785-312-0474
Practice Address - Fax:888-607-5875
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-28
Last Update Date:2012-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1042103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS119629Medicare ID - Type Unspecified