Individual
DR. NICOLE YLONNE PAYNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
100 DOCTORS DR, SUITE I, DOUGLAS, GA 31533-2210
(912) 383-6575
(912) 383-6476
Mailing address
460 MALL BLVD, SUITE B, SAVANNAH, GA 31406-4801
(912) 644-5300
(912) 644-3369
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
068269
GA
208100000X
Physical Medicine & Rehabilitation Physician
35.091613
OH
208100000X
Physical Medicine & Rehabilitation Physician
MD60463507
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1508994
—
TN
01
—
326916
STATE L&I
WA
01
—
P00703245
RRMCR
TN
Enumeration date
05/14/2008
Last updated
10/03/2016
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