Individual
DR. LYNNETTA FAITH PAYNE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
1717 HARPER RD, THIRD FLOOR, SUITE A&B, BECKLEY, WV 25801-3373
(304) 461-3879
(304) 461-0256
Mailing address
1717 HARPER RD, THIRD FLOOR SUITE A&B, BECKLEY, WV 25801-3373
(304) 461-3879
(304) 461-3858
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
2330
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
51D2046168
CLIA
—
01
—
WV1663A
MEDICARE PTAN
WV
Enumeration date
08/29/2007
Last updated
06/04/2013
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