| Tylor Scott Payne, CAA | |
|
1102 W 32nd St, Joplin, MO 64804-3503 | |
| (417) 347-1111 | |
| Not Available |
| Full Name | Tylor Scott Payne |
|---|---|
| Gender | Male |
| Speciality | Anesthesiologist Assistant |
| Location | 1102 W 32nd St, Joplin, Missouri |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538873807 | NPI | - | NPPES |
| 1102822179 | Other | IN | ANTHEM PTAN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 367H00000X | Anesthesiologist Assistant | 32698366 (Wisconsin) | Secondary |
| 367H00000X | Anesthesiologist Assistant | 75000128A (Indiana) | Primary |
| Entity Name | Freeman-oak Hill Health System |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1679517023 PECOS PAC ID: 8325942253 Enrollment ID: O20040218000570 |
| Mailing Address | Practice Location Address |
|---|---|
| Tylor Scott Payne, CAA 250 N Shadeland Ave, Indianapolis, IN 46219-4959 Ph: () - | Tylor Scott Payne, CAA 1102 W 32nd St, Joplin, MO 64804-3503 Ph: (417) 347-1111 |
Sally Ann Mitchell, CAA Anesthesiologist Assistant Medicare: Medicare Enrolled Practice Location: 1102 W 32nd St, Joplin, MO 64804 Phone: 417-347-5222 | |
Wesley Middleton, CAA Anesthesiologist Assistant Medicare: Medicare Enrolled Practice Location: 1102 W 32nd St, Joplin, MO 64804 Phone: 417-347-1111 | |
Rocky Kyser, CAA Anesthesiologist Assistant Medicare: Medicare Enrolled Practice Location: 1102 W 32nd St, Joplin, MO 64804 Phone: 417-347-1111 |