Provider Demographics
NPI:1194160424
Name:PAYTON, SARAH ANN
Entity type:Individual
Prefix:MS
First Name:SARAH
Middle Name:ANN
Last Name:PAYTON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5637 HEARD ST
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:MS
Mailing Address - Zip Code:39206-2907
Mailing Address - Country:US
Mailing Address - Phone:601-709-7830
Mailing Address - Fax:
Practice Address - Street 1:5637 HEARD ST
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:MS
Practice Address - Zip Code:39206-2907
Practice Address - Country:US
Practice Address - Phone:601-709-7830
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-30
Last Update Date:2013-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor