Individual
DR. MICHAEL STEPHEN PAYNE JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
800 E CARPENTER ST, SPRINGFIELD, IL 62769-4564
(217) 528-7541
Mailing address
1025 S 6TH ST, SPRINGFIELD, IL 62703-2403
(217) 528-7541
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
036147769
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
166668701
—
TX
05
—
166668702
—
TX
05
—
166668703
—
TX
01
—
8R1524
BLUE CROSS OF TEXAS
TX
Enumeration date
06/14/2006
Last updated
09/26/2019
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