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Individual

MICHAEL S PAYNE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
532 N BARDSTOWN RD, MT WASHINGTON, KY 40047
(502) 538-4800
(502) 538-3040
Mailing address
532 N BARDSTOWN RD, PO BOX 67, MT WASHINGTON, KY 40047
(502) 538-4800
(502) 538-3040

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
34039
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000306485
BCBS
01
2443395000
PASSPORT ADVANTAGE
01
50001836
PASSPORT
KY
05
64011109
KY
01
7088131
AETNA
01
P00080686
RAILROAD MEDICARE
Enumeration date
09/05/2006
Last updated
11/14/2011
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