Basic Information
| Provider Information | |||||||||
| NPI: | 1598023962 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | PAYNE | ||||||||
| FirstName: | SAKEENA | ||||||||
| MiddleName: | JAMALUDDIN | ||||||||
| NamePrefix: | |||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | JAMALUDDIN | ||||||||
| OtherFirstName: | SAKEENA | ||||||||
| OtherMiddleName: | SHABBIR | ||||||||
| OtherNamePrefix: | |||||||||
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| OtherCredential: | MD | ||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 5220 W UNIVERSITY DR STE 150 | ||||||||
| Address2: | |||||||||
| City: | MCKINNEY | ||||||||
| State: | TX | ||||||||
| PostalCode: | 750717418 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9729841050 | ||||||||
| FaxNumber: | 9729841376 | ||||||||
| Practice Location | |||||||||
| Address1: | 924 COLONIAL AVE STE E | ||||||||
| Address2: | |||||||||
| City: | YORK | ||||||||
| State: | PA | ||||||||
| PostalCode: | 174033450 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7178439089 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/24/2012 | ||||||||
| LastUpdateDate: | 01/20/2020 | ||||||||
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| NPIReactivationDate: | |||||||||
| ProviderGenderCode: | F | ||||||||
| AuthorizedOfficialLastName: | |||||||||
| AuthorizedOfficialFirstName: | |||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | |||||||||
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| IsSoleProprietor: | N | ||||||||
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| AuthorizedOfficialNameSuffix: | |||||||||
| AuthorizedOfficialCredential: | |||||||||
| NPICertificationDate: | 01/20/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Y00000X | MD463966 | PA | N | Allopathic & Osteopathic Physicians | Otolaryngology | 207Y00000X | S0056 | TX | Y | Allopathic & Osteopathic Physicians | Otolaryngology |
No ID Information.