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1194407379
JACKSON PAYNE
ROGERS, AR
NPI
1194407379
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363LP2300X Nurse Practitioner, Primary Care
(Licence: AR 226845)
Enumeration Date
2023-08-07
Last Update Date
2024-01-19
Business Address
JACKSON PAYNE
2708 S RIFE MEDICAL LN STE 210
ROGERS, AR 72758-1456
Phone number: 479-338-3888
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Mailing Address
JACKSON PAYNE
PO BOX 776084
CHICAGO, IL 60677-6084
Phone number: 314-364-4200
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