Provider Demographics
NPI:1124268313
Name:PAYNE, NETTLETON S II (MD)
Entity type:Individual
Prefix:DR
First Name:NETTLETON
Middle Name:S
Last Name:PAYNE
Suffix:II
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:3586 TUXEDO PARK NW
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30305-1041
Mailing Address - Country:US
Mailing Address - Phone:404-262-1043
Mailing Address - Fax:404-262-1264
Practice Address - Street 1:3586 TUXEDO PARK NW
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30305-1041
Practice Address - Country:US
Practice Address - Phone:404-262-1043
Practice Address - Fax:404-262-1264
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-27
Last Update Date:2009-02-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA016406207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery