Individual
DR. JOHN PAYNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
969 LAKELAND DR, JACKSON, MS 39216-4606
(601) 200-4644
(601) 200-4645
Mailing address
PO BOX 677957, DALLAS, TX 75267-7957
(225) 765-5727
(225) 765-4278
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
17050
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00123114
—
MS
01
—
110239904
MEDICARE RAILROAD
MS
Enumeration date
03/17/2006
Last updated
08/05/2022
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