Individual
DR. DERRICK PAYNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
311 N CLYDE MORRIS BLVD, SUITE 350, DAYTONA BEACH, FL 32114-2781
(386) 255-1266
(386) 255-8520
Mailing address
311 N CLYDE MORRIS BLVD, SUITE 350, DAYTONA BEACH, FL 32114-2781
(386) 255-1266
(386) 255-8520
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
ME0065671
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
374869300
—
FL
Enumeration date
07/13/2006
Last updated
07/08/2007
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