Provider Demographics
NPI:1780725895
Name:PAYNE, WILLIAM MCMICHAEL II (PHARMD)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:MCMICHAEL
Last Name:PAYNE
Suffix:II
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:71 LAKEVIEW
Mailing Address - Street 2:
Mailing Address - City:STANSBURY PARK
Mailing Address - State:UT
Mailing Address - Zip Code:84074-9608
Mailing Address - Country:US
Mailing Address - Phone:435-882-7933
Mailing Address - Fax:
Practice Address - Street 1:71 LAKEVIEW
Practice Address - Street 2:
Practice Address - City:STANSBURY PARK
Practice Address - State:UT
Practice Address - Zip Code:84074-9608
Practice Address - Country:US
Practice Address - Phone:435-882-7933
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT5297852-1701183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist