Provider Demographics
NPI:1134249063
Name:PAYNE CLINIC, PA
Entity type:Organization
Organization Name:PAYNE CLINIC, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRES
Authorized Official - Prefix:DR
Authorized Official - First Name:BRYAN
Authorized Official - Middle Name:KENDALL
Authorized Official - Last Name:PAYNE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:913-386-5100
Mailing Address - Street 1:11011 KING ST STE 105
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66210-1203
Mailing Address - Country:US
Mailing Address - Phone:913-386-5100
Mailing Address - Fax:913-386-5102
Practice Address - Street 1:11011 KING ST STE 105
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66210-1203
Practice Address - Country:US
Practice Address - Phone:913-386-5100
Practice Address - Fax:913-386-5102
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-02
Last Update Date:2023-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS01-4751111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS36371015OtherBCBSKC
KSP490000Medicare PIN
KS36371015OtherBCBSKC