Provider Demographics
NPI:1972125227
Name:PAYNE, SVITLANA N (RT(R) (MR) ARRT)
Entity type:Individual
Prefix:
First Name:SVITLANA
Middle Name:N
Last Name:PAYNE
Suffix:
Gender:F
Credentials:RT(R) (MR) ARRT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:593 KELLY FARM RD
Mailing Address - Street 2:
Mailing Address - City:NEWNAN
Mailing Address - State:GA
Mailing Address - Zip Code:30265-1416
Mailing Address - Country:US
Mailing Address - Phone:404-960-6302
Mailing Address - Fax:
Practice Address - Street 1:593 KELLY FARM RD
Practice Address - Street 2:
Practice Address - City:NEWNAN
Practice Address - State:GA
Practice Address - Zip Code:30265-1416
Practice Address - Country:US
Practice Address - Phone:404-960-6302
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-09
Last Update Date:2020-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA5661892471M1202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2471M1202XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistMagnetic Resonance Imaging