Payne, Jordan
Payne, Jordan is an individual health care provider with primary practice located at 400 Rosalind Redfern Grover Pkwy , Midland TX 79701-5846. He recently has 2 registered licenses in different health care specialties including Student, Health Care / Student in an Organized Health Care Education/Training Program, Allopathic & Osteopathic Physicians / Pediatrics. Allopathic & Osteopathic Physicians / Pediatrics is his primary health care specialty. Payne, Jordan can be contacted via phone (432) 221-1111.Contact Information
Primary practice address
400 Rosalind Redfern Grover Pkwy
Midland TX 79701-5846
Phone: (432) 221-1111
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Student, Health Care / Student in an Organized Health Care Education/Training Program | 390200000X | ||
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | R2440 | Texas |
Profile Details
| NPI number | 1558775171 |
|---|---|
| LBN Legal business name | Payne, Jordan |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 12th, 2014 |
| Last updated | Mar 17th, 2018 - about 7 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1558775171 | NPPES |
| Texas | Other | 8HA174 | BCBS |
| Texas | Other | 583266YKT8 | BCBS |
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