Individual
KATHERINE J PAYNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
701 NE 36TH ST, OKLAHOMA CITY, OK 73105-7203
(405) 631-0611
(405) 631-0811
Mailing address
701 NE 36TH ST, OKLAHOMA CITY, OK 73105-7203
(405) 631-0611
(405) 631-0811
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
1189
OK
363AS0400X
Surgical Physician Assistant
1189
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200015710A
—
OK
Enumeration date
10/19/2005
Last updated
06/13/2014
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