Individual
DR. KASSANDRA L PAYNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
104 WALL ST, POTEAU, OK 74953
(918) 647-8635
(918) 635-3191
Mailing address
PO BOX 689, POTEAU, OK 74953-0689
(918) 647-8635
(918) 635-3191
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
5982
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
373479
—
OK
Enumeration date
06/02/2015
Last updated
09/07/2018
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