1598738049 NPI number — DR. CRAIG SCOTT TURNER SR. MD

Table of content: DR. CRAIG SCOTT TURNER SR. MD (NPI 1598738049)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1598738049 NPI number — DR. CRAIG SCOTT TURNER SR. MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
TURNER
Provider First Name:
CRAIG
Provider Middle Name:
SCOTT
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
SR.
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
TURNER
Provider Other First Name:
CRAIG
Provider Other Middle Name:
SCOTT
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
SR.
Provider Other Credential Text:
MD
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1598738049
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/17/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 14656
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MONROE
Provider Business Mailing Address State Name:
LA
Provider Business Mailing Address Postal Code:
71207
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
318-343-6487
Provider Business Mailing Address Fax Number:
318-343-7884

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
516 LINCOLN ROAD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MONROE
Provider Business Practice Location Address State Name:
LA
Provider Business Practice Location Address Postal Code:
71203
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
318-343-6487
Provider Business Practice Location Address Fax Number:
318-343-7884
Provider Enumeration Date:
02/07/2006

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: 207Q00000X , with the licence number:  015507 , registered in the state of LA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 1302091 , issued by the state of ( LA ) . This identifiers is of the category "MEDICAID".




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