1215079280 NPI number — ALYSSA LEIGH TURNER M.D.

Table of content: ALYSSA LEIGH TURNER M.D. (NPI 1215079280)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1215079280 NPI number — ALYSSA LEIGH TURNER M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
TURNER
Provider First Name:
ALYSSA
Provider Middle Name:
LEIGH
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
GUY
Provider Other First Name:
ALYSSA
Provider Other Middle Name:
LEIGH
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1215079280
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/09/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
P.O. BOX 2469
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LOUISVILLE
Provider Business Mailing Address State Name:
KY
Provider Business Mailing Address Postal Code:
40201-2469
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
502-852-8500
Provider Business Mailing Address Fax Number:
502-852-8556

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
231 EAST CHESTNUT STREET
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LOUISVILLE
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
40202-1821
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
502-629-6000
Provider Business Practice Location Address Fax Number:
502-852-8556
Provider Enumeration Date:
02/13/2007

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: 208000000X , with the licence number:  R1111 , registered in the state of KY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 208000000X , with the licence number: 41606 , registered in the state of KY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 200907160 , issued by the state of ( IN ) . This identifiers is of the category "MEDICAID".
  • Identifier: 7100047610 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".