Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YX0905X | Otolaryngology/Facial Plastic Surgery | DR.0048772 | CO |
NPI | 1568450542 |
---|---|
Provider Name | Harry H Payton |
First Address | Salida, CO 81201-9669 |
Second Address | Salida, CO 81201-9669 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/10/2005 |
Last Update Date | 22/08/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
002298 | ANTHEM (01) | ME |
1044199 | AETNA (01) | ME |
AX5099 | MEDICARE PTAN GRP 152556 (01) | ME |
E16975 | (02) | ME |
E16975 | HARVARD PILGRIM (01) | ME |
HX1692 | MEDICARE PTAN GRP MM8648 (01) | ME |