Provider Demographics
NPI:1952475055
Name:PAYTON OPTICAL INC
Entity Type:Organization
Organization Name:PAYTON OPTICAL INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP TREASURER
Authorized Official - Prefix:MRS
Authorized Official - First Name:PAULA
Authorized Official - Middle Name:J
Authorized Official - Last Name:PAYTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:620-662-5081
Mailing Address - Street 1:122 NORTH MAIN
Mailing Address - Street 2:
Mailing Address - City:HUTCHINSON
Mailing Address - State:KS
Mailing Address - Zip Code:67501
Mailing Address - Country:US
Mailing Address - Phone:620-662-5081
Mailing Address - Fax:620-665-8387
Practice Address - Street 1:122 NORTH MAIN
Practice Address - Street 2:
Practice Address - City:HUTCHINSON
Practice Address - State:KS
Practice Address - Zip Code:67501
Practice Address - Country:US
Practice Address - Phone:620-662-5081
Practice Address - Fax:620-665-8387
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOpticianGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS0349000001Medicare ID - Type Unspecified