Individual
STEPHEN R PAYNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
148 FAIRFIELD ST, ST ALBANS, VT 05478-1729
(802) 524-2168
(802) 524-0411
Mailing address
PO BOX 166, ST ALBANS, VT 05478-0166
(802) 524-2168
(802) 524-0411
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
0420007703
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0009263
—
VT
01
—
02V011
MVP HEALTH CARE
VT
01
—
28637
BLUE CROSS BLUE SHIELD
VT
01
—
4671301
FAHC PREFERRED
VT
Enumeration date
10/24/2005
Last updated
07/08/2007
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