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Individual
JOHN L. PAYNE
Active
Individual
JOHN L. PAYNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
002770
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004082202
—
CT
01
—
08-0002770CT01
ANTHEM BC/BS
CT
01
—
508878
AETNA
CT
01
—
CD8409
RR MEDICARE
CT
Enumeration date
05/01/2006
Last updated
11/08/2012
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