Provider Demographics
NPI:1780199851
Name:PAYE, JULIAN E (RPT)
Entity Type:Individual
Prefix:
First Name:JULIAN
Middle Name:E
Last Name:PAYE
Suffix:
Gender:M
Credentials:RPT
Other - Prefix:MR
Other - First Name:JULIAN
Other - Middle Name:EUSENA
Other - Last Name:PAAYE
Other - Suffix:JR
Other - Last Name Type:Professional Name
Other - Credentials:JULIAN PAYE
Mailing Address - Street 1:2024 COLUMBUS ST
Mailing Address - Street 2:
Mailing Address - City:MUSKOGEE
Mailing Address - State:OK
Mailing Address - Zip Code:74401-5235
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1029 E WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:MCALESTER
Practice Address - State:OK
Practice Address - Zip Code:74501-4849
Practice Address - Country:US
Practice Address - Phone:918-423-2220
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-12-11
Last Update Date:2023-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LACP010888T225100000X
MSCP010889T225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist