Basic Information
Provider Information | |||||||||
NPI: | 1104055607 | ||||||||
EntityType: | 1 | ||||||||
ReplacementNPI: |   | ||||||||
OrganizationName: |   | ||||||||
LastName: | PAYSINGER | ||||||||
FirstName: | ANNA | ||||||||
MiddleName: | KRISTEN | ||||||||
NamePrefix: | DR. | ||||||||
NameSuffix: |   | ||||||||
Credential: | M.D. | ||||||||
OtherOrganizationName: |   | ||||||||
OtherOrganizationType: |   | ||||||||
OtherLastName: |   | ||||||||
OtherFirstName: |   | ||||||||
OtherMiddleName: |   | ||||||||
OtherNamePrefix: |   | ||||||||
OtherNameSuffix: |   | ||||||||
OtherCredential: |   | ||||||||
OtherLastNameType: |   | ||||||||
Mailing Information | |||||||||
Address1: | PO BOX 748118 | ||||||||
Address2: |   | ||||||||
City: | LOS ANGELES | ||||||||
State: | CA | ||||||||
PostalCode: | 900748118 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 8009623303 | ||||||||
FaxNumber: | 4076493083 | ||||||||
Practice Location | |||||||||
Address1: | 302 UNIVERSITY PKWY | ||||||||
Address2: |   | ||||||||
City: | AIKEN | ||||||||
State: | SC | ||||||||
PostalCode: | 298016302 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 8036415100 | ||||||||
FaxNumber: | 8036415690 | ||||||||
Other Information | |||||||||
ProviderEnumerationDate: | 07/07/2009 | ||||||||
LastUpdateDate: | 12/21/2017 | ||||||||
NPIDeactivationReasonCode: |   | ||||||||
NPIDeactivationDate: |   | ||||||||
NPIReactivationDate: |   | ||||||||
ProviderGenderCode: | F | ||||||||
AuthorizedOfficialLastName: |   | ||||||||
AuthorizedOfficialFirstName: |   | ||||||||
AuthorizedOfficialMiddleName: |   | ||||||||
AuthorizedOfficialTitleorPosition: |   | ||||||||
AuthorizedOfficialTelephone: |   | ||||||||
IsSoleProprietor: | N | ||||||||
IsOrganizationSubpart: |   | ||||||||
ParentOrganizationLBN: |   | ||||||||
AuthorizedOfficialNamePrefix: |   | ||||||||
AuthorizedOfficialNameSuffix: |   | ||||||||
AuthorizedOfficialCredential: |   | ||||||||
NPICertificationDate: |   |
Taxonomy Information
Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 390200000X | TRN13723 | FL | N |   | Student, Health Care | Student in an Organized Health Care Education/Training Program |   | 207P00000X | 40054 | SC | Y |   | Allopathic & Osteopathic Physicians | Emergency Medicine |   |
No ID Information.