Individual
JEFFREY L PAYNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3844 1ST AVE, EVANSVILLE, IN 47710-3326
(812) 428-6161
(812) 421-2883
Mailing address
PO BOX 3407, EVANSVILLE, IN 47733-3407
(812) 428-6161
(812) 421-2883
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01034143A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200531110
—
IN
01
—
P00251056
RR MEDICARE
IN
Enumeration date
03/17/2006
Last updated
03/09/2011
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