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Individual
AMY MARIE CRAYCRAFT PAYNE
Active
Individual
AMY MARIE CRAYCRAFT PAYNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
30432
SC
207Q00000X
Family Medicine Physician
58048
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
058408
STATE OF GEORGIA LICENSE
GA
01
—
102I081896
MEDICARE
GA
01
—
20-30432
SC CONTROLLED SUBSTANCES
SC
01
—
30432
SC MEDICAL LICENSE
SC
05
—
G58408
—
SC
01
—
SC5305D839
MEDICARE
SC
Enumeration date
08/23/2006
Last updated
03/07/2023
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