Provider Demographics
NPI:1831189398
Name:PAYNE, JOSEPH R (MD)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:R
Last Name:PAYNE
Suffix:
Gender:
Credentials:MD
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Mailing Address - Street 1:5555 PEACHTREE DUNWOODY ROAD NE
Mailing Address - Street 2:SUITE 190
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30342-1710
Mailing Address - Country:US
Mailing Address - Phone:404-256-4457
Mailing Address - Fax:404-843-3469
Practice Address - Street 1:DERMATOLOGY ASSOCIATES OF ATLANTA, PC
Practice Address - Street 2:5555 PEACHTREE DUNWOODY ROAD NE SUITE 190
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30342-1710
Practice Address - Country:US
Practice Address - Phone:404-256-4457
Practice Address - Fax:404-843-3469
Is Sole Proprietor?:No
Enumeration Date:2005-10-26
Last Update Date:2025-05-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME91573207ND0101X
GAGA.59889207N00000X
FLME 91573207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
No207ND0101XAllopathic & Osteopathic PhysiciansDermatologyMOHS-Micrographic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLI28336Medicare UPIN
FL52112AMedicare ID - Type Unspecified