IndividualActive
Payton Fennell, D.O
NPI 1306906086 · Sports Medicine (Family Medicine) Physician · Charlotte, NC
Provider details
- NPI number
- 1306906086
- Entity type
- Individual
- Primary specialty
- Sports Medicine (Family Medicine) PhysicianAllopathic & Osteopathic Physicians
- Credential
- D.O
- Sex
- Male
- Sole proprietor
- Yes
- License
- 200601317 (NC)
Practice location
4741 Randolph Rd
Charlotte, NC 28211-2919
Phone: (704) 365-6730
Fax: (704) 365-6731
Mailing address
52 12th Ave Ne
Hickory, NC 28601-2798
Registry dates
- Enumerated
- 2006-12-11
- Last updated
- 2021-06-14
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.