Provider Demographics
NPI:1912195272
Name:PAYNE & PAYNE, PC
Entity Type:Organization
Organization Name:PAYNE & PAYNE, PC
Other - Org Name:SOUTH FORSYTH/ALPHARETTA EYECARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:WADE
Authorized Official - Last Name:PAYNE
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:770-232-7844
Mailing Address - Street 1:4330 JOHNS CREEK PKWY
Mailing Address - Street 2:SUITE 300
Mailing Address - City:SUWANEE
Mailing Address - State:GA
Mailing Address - Zip Code:30024-6047
Mailing Address - Country:US
Mailing Address - Phone:770-232-7844
Mailing Address - Fax:770-232-9455
Practice Address - Street 1:4330 JOHNS CREEK PKWY
Practice Address - Street 2:SUITE 300
Practice Address - City:SUWANEE
Practice Address - State:GA
Practice Address - Zip Code:30024-6047
Practice Address - Country:US
Practice Address - Phone:770-232-7844
Practice Address - Fax:770-232-9455
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-11
Last Update Date:2021-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA1220152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GADG5938OtherRAILROAD MEDICARE
GAGRP4578Medicare PIN