Individual
HERNANDO C PAYNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1727 E UNION ST, GREENVILLE, MS 38703-3253
(662) 332-0373
Mailing address
PO BOX 23998, JACKSON, MS 39225-3998
(662) 725-2749
(662) 725-2741
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
08032
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00011061
—
MS
05
—
162022001
—
AR
Enumeration date
08/11/2006
Last updated
06/25/2008
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