Individual
JACQUELYN DENISE PAYNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
840 PINE ST STE 500, MACON, GA 31201-7530
(478) 633-8682
(478) 633-8698
Mailing address
840 PINE ST STE 500, MACON, GA 31201-7530
(478) 633-8682
(478) 633-8698
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
9008
GA
Other
Enumeration date
10/10/2018
Last updated
09/28/2023
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