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Individual

WILLIAM THOMAS PAYNE V

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
27650 FERRY RD, WARRENVILLE, IL 60555
(630) 225-2663
Mailing address
27650 FERRY RD, WARRENVILLE, IL 60555
(630) 225-2663

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
49329
CO
207XS0106X
Orthopaedic Hand Surgery Physician
Primary
036-136592
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
206147
MEDICARE PTAN (GROUP)
IL
05
45458049
CO
01
F400181679
MEDICARE PTAN (INDIVIDUAL)
IL
Enumeration date
05/16/2007
Last updated
12/24/2014
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