Individual
TIFFANI PAYNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5211 COMMERCE CROSSINGS DR, LOUISVILLE, KY 40229-2183
(502) 966-3918
(502) 969-3665
Mailing address
PO BOX 776351, CHICAGO, IL 60677-6351
(502) 588-9490
(502) 272-5116
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
53099
KY
208000000X
Pediatrics Physician
TP09
KY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100496000
—
KY
Enumeration date
03/30/2016
Last updated
09/04/2024
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