Provider Demographics
NPI:1134264872
Name:PAYNE, R REX (MD)
Entity type:Individual
Prefix:DR
First Name:R
Middle Name:REX
Last Name:PAYNE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:48 MEDICAL PARK DR E
Mailing Address - Street 2:SUITE 458
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35235-3400
Mailing Address - Country:US
Mailing Address - Phone:205-838-1811
Mailing Address - Fax:205-838-5958
Practice Address - Street 1:48 MEDICAL PARK DR E
Practice Address - Street 2:SUITE 458
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35235-3400
Practice Address - Country:US
Practice Address - Phone:205-838-1811
Practice Address - Fax:205-838-5958
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-20
Last Update Date:2008-06-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AL00006700207ND0900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ND0900XAllopathic & Osteopathic PhysiciansDermatologyDermatopathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL051078860OtherBC BS OF ALABAMA
AL000078860Medicaid
AL000078860Medicare ID - Type Unspecified
ALC71882Medicare UPIN