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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

DR. PAYTON GREGORY FENNELL, D.O

Active Sole Proprietor

Sports Medicine · CHARLOTTE, NC

Registration Details

NPI Number
1306906086
Provider Type
Individual
Gender
Male
NPI Issued
Dec 11, 2006 (19.362863682355 yrs)
Last Updated
Jun 14, 2021
Licenses
200601317 (NC)
200601317 (NC)
Sole Proprietor
Yes

Practice Information

Address
4741 RANDOLPH RD
CHARLOTTE, NC, 282112919
Browse NC providers · Browse ZIP 28211
Phone
7043656730
Fax
7043656731
Primary Specialty
Sports Medicine
207QS0010X
Additional Specialty
Sports Medicine

Other Sports Medicine Providers in CHARLOTTE, NC

Name Credential NPI
DR. AARON GREGORY ELLISON MD 1730154659
DAVID EVAN PRICE MD 1912937665
MR. CHRISTOPHER CLAUDE FELTON D.O. 1730222332
ERIC THOMAS WARREN MD 1831220292
CATHERINE R. RAINBOW MD 1598970840
AUGUSTUS GARLAND PARKER IV M.D. 1285868117
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.