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MELVIN PELLETIER PAYNE III

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
2996 KATE BOND RD, SUITE 309, BARTLETT, TN 38133-4030
(901) 726-1056
(901) 726-5867
Mailing address
6029 WALNUT GROVE RD, SUITE 404, MEMPHIS, TN 38120-2112
(901) 726-1056
(901) 726-5867

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
29662
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3816845
TN
01
P00135739
RAILROAD MEDICARE
TN
Enumeration date
08/30/2006
Last updated
12/12/2007
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