Tylor Scott Payne, CAA | |
1102 W 32nd St, Joplin, MO 64804-3503 | |
(417) 347-1111 | |
Not Available |
Full Name | Tylor Scott Payne |
---|---|
Gender | Male |
Speciality | Anesthesiologist Assistant |
Location | 1102 W 32nd St, Joplin, Missouri |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1538873807 | NPI | - | NPPES |
095200125 | Other | IN | MEDICARE PTAN |
1102822179 | Other | IN | ANTHEM PTAN |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
367H00000X | Anesthesiologist Assistant | 32698366 (Wisconsin) | Primary |
367H00000X | Anesthesiologist Assistant | 75000128A (Indiana) | Secondary |
Entity Name | Freeman-oak Hill Health System |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1679517023 PECOS PAC ID: 8325942253 Enrollment ID: O20040218000570 |
Mailing Address | Practice Location Address |
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Tylor Scott Payne, CAA 250 N Shadeland Ave, Indianapolis, IN 46219-4959 Ph: () - | Tylor Scott Payne, CAA 1102 W 32nd St, Joplin, MO 64804-3503 Ph: (417) 347-1111 |
Sally Ann Mitchell, CAA Anesthesiologist Assistant Medicare: Medicare Enrolled Practice Location: 1102 W 32nd St, Joplin, MO 64804 Phone: 417-347-5222 | |
Wesley Middleton, CAA Anesthesiologist Assistant Medicare: Not Enrolled in Medicare Practice Location: 1102 W 32nd St, Joplin, MO 64804 Phone: 417-347-1111 | |
Rocky Kyser, CAA Anesthesiologist Assistant Medicare: Not Enrolled in Medicare Practice Location: 1102 W 32nd St, Joplin, MO 64804 Phone: 417-347-1111 |