Individual
KEEGAN PAYNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2215 BURDETT AVENUE, TROY, NY 12180-2466
(518) 271-3300
(515) 525-6545
Mailing address
18618 SOUTHARD OAKS DR, CYPRESS, TX 77429-7769
(443) 939-0701
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
100495-875
WI
207L00000X
Anesthesiology Physician
310406
NY
207L00000X
Anesthesiology Physician
BP10057137
TX
207L00000X
Anesthesiology Physician
U4597
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100231438
—
WI
Enumeration date
05/04/2016
Last updated
03/28/2024
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