Payton, Jacqueline Elise
Payton, Jacqueline Elise is an individual health care provider with primary practice located at 4320 Forest Park Ave Div Pa Lab And Genomic Med, Ste 209, Saint Louis MO 63108-2979. She recently has only one registered license in Allopathic & Osteopathic Physicians / Clinical Pathology/Laboratory Medicine, which is considered as her primary health care specialty. Payton, Jacqueline Elise can be contacted via phone (314) 362-5641.Contact Information
Primary practice address
4320 Forest Park Ave Div Pa Lab And Genomic Med, Ste 209
Saint Louis MO 63108-2979
Phone: (314) 362-5641
Fax: (314) 362-0369
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Clinical Pathology/Laboratory Medicine | 207ZP0105X | 2008022583 | Missouri |
Profile Details
| NPI number | 1750407714 |
|---|---|
| LBN Legal business name | Payton, Jacqueline Elise |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 22nd, 2007 |
| Last updated | Apr 25th, 2024 - about 8 months 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 | 1750407714 | NPPES |
| Missouri | MEDICAID | 200118891 |
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