Basic Information
| Provider Information | |||||||||
| NPI: | 1477686376 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | KAYYE | ||||||||
| FirstName: | PAUL | ||||||||
| MiddleName: | THOMAS | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1633 MASSENGILL POND RD | ||||||||
| Address2: | |||||||||
| City: | ANGIER | ||||||||
| State: | NC | ||||||||
| PostalCode: | 275019398 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9196396229 | ||||||||
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| Practice Location | |||||||||
| Address1: | 215 MEMORIAL DR | ||||||||
| Address2: | |||||||||
| City: | JACKSONVILLE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 285466333 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9103535118 | ||||||||
| FaxNumber: | 9105771338 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/13/2007 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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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 | 2084P0800X | 15656 | NC | Y | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Psychiatry |
ID Information
| ID | Type | State | Issuer | Description | AK4905622 | 01 | NC | DEA NUMBER | OTHER |