1023172004 NPI number — SAM PHILLIP TURMAN

Table of content: SAM PHILLIP TURMAN (NPI 1023172004)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1023172004 NPI number — SAM PHILLIP TURMAN

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
TURMAN
Provider First Name:
SAM
Provider Middle Name:
PHILLIP
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1023172004
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2675 DIAS PL APT A
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
KAILUA
Provider Business Mailing Address State Name:
HI
Provider Business Mailing Address Postal Code:
96734-4749
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
760-207-6598
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1ST BATTALIOON 3D MARINES 3D MARDIV FMF
Provider Second Line Business Practice Location Address:
HEAEDQUARTERS AND SERVICE COMPANY
Provider Business Practice Location Address City Name:
MCBH KANEOHE BAY
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96863
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-257-5131
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
12/21/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1710I1002X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)