Individual
MRS. MALIQUE ROXANNE PAYNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
125 PAVILION PKWY, FAYETTEVILLE, GA 30214-4098
(770) 460-7894
(770) 719-4392
Mailing address
125 PAVILION PKWY, FAYETTEVILLE, GA 30214-4098
(770) 460-7894
(770) 719-4392
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPT002483
GA
152W00000X
Optometrist
R-227-TA-984
AL
152W00000X
Optometrist
TUV007182
NY
Other
Enumeration date
09/13/2007
Last updated
07/13/2020
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