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Individual

MR. GERALD E PAYNE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
286 US HIGHWAY 23 N, SUITE 102, PRESTONSBURG, KY 41653-8732
(606) 874-0032
(606) 874-0064
Mailing address
2465 WOODFIELD CIR, LEXINGTON, KY 40515-1224
(859) 272-7573

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA406
KY
363AM0700X
Medical Physician Assistant
Primary
PA406
KY
363AS0400X
Surgical Physician Assistant
PA406

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
95002226
KY
Enumeration date
01/04/2006
Last updated
05/12/2021
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