Individual
MR. JAMES R PAYNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA C
Contact information
Practice address
1 MEADOWS PKWY, VIDALIA, GA 30474-8759
(912) 454-7012
(866) 871-8565
Mailing address
PO BOX 749495, ATLANTA, GA 30374-9495
(239) 432-8331
(813) 321-1296
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
4295
GA
363AM0700X
Medical Physician Assistant
004295
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
576258321A
—
GA
Enumeration date
09/13/2005
Last updated
05/05/2025
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