Organization
MT WASHINGTON FAMILY PRACTICE PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL STEVEN PAYNE M.D. (OWNER)
(502) 955-5800
Entity
Organization
Contact information
Practice address
532 BARDSTOWN RD N, MT WASHINGTON, KY 40047
(502) 955-5800
(502) 538-3040
Mailing address
PO BOX 67, MT WASHINGTON, KY 40047-0067
(502) 955-5800
(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
KY
01
—
2443395000
PASSPORT ADVANTAGE
KY
05
—
64011109
—
KY
01
—
7088131
AETNA
KY
01
—
DA9753
RAILROAD MEDICARE
KY
Enumeration date
02/26/2007
Last updated
09/19/2007
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