Individual
MR. JACKSON LEE PAYNE II
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
3574 HICKORY HILL ROAD, MEMPHIS, TN 38115
(901) 365-9054
(901) 365-1159
Mailing address
3574 HICKORY HILL ROAD, MEMPHIS, TN 38115
(901) 365-9054
(901) 365-1159
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DS5420
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3225937
—
TN
Enumeration date
10/23/2006
Last updated
07/08/2007
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