Individual
DR. JACQUELINE ELISE PAYTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
4320 FOREST PARK AVE, DIV PA LAB AND GENOMIC MED, STE 209, SAINT LOUIS, MO 63108-2979
(314) 362-5641
(314) 362-0369
Mailing address
PO BOX 7412011, CHICAGO, IL 60674-2011
(314) 362-5641
(314) 362-0369
Taxonomy
Speciality
Code
Description
License number
State
207ZP0105X
Clinical Pathology/Laboratory Medicine Physician
Primary
2008022583
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200118891
—
MO
Enumeration date
03/22/2007
Last updated
04/17/2025
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