Individual
AMY MARIE CRAYCRAFT PAYNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1201 WEST AVE, NORTH AUGUSTA, SC 29841-3350
(803) 279-1030
(803) 278-1344
Mailing address
3686 WHEELER RD, AUGUSTA, GA 30909-6520
(706) 922-6300
(706) 922-6303
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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