Basic Information
| Provider Information | |||||||||
| NPI: | 1467660910 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | PAYNE | ||||||||
| FirstName: | KYLE | ||||||||
| MiddleName: | D | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 131 SAUNDERSVILLE RD | ||||||||
| Address2: | SUITE 160 | ||||||||
| City: | HENDERSONVILLE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 370758903 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9012032901 | ||||||||
| FaxNumber: | 9017796968 | ||||||||
| Practice Location | |||||||||
| Address1: | 176 BRIARWOOD ST STE B | ||||||||
| Address2: | |||||||||
| City: | CAMDEN | ||||||||
| State: | TN | ||||||||
| PostalCode: | 383201456 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7312132720 | ||||||||
| FaxNumber: | 7313500677 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/18/2007 | ||||||||
| LastUpdateDate: | 10/11/2018 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207L00000X | 49837 | TN | N | Allopathic & Osteopathic Physicians | Anesthesiology | 207LP2900X | 49837 | TN | Y | Allopathic & Osteopathic Physicians | Anesthesiology | Pain Medicine |
No ID Information.