1851562706 NPI number — TURNER MEDICAL CLINIC INC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1851562706 NPI number — TURNER MEDICAL CLINIC INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
TURNER MEDICAL CLINIC INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

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:
1851562706
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/31/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
P.O. BOX 2427
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LITTLE ROAD
Provider Business Mailing Address State Name:
AR
Provider Business Mailing Address Postal Code:
72203-2427
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
501-375-6511
Provider Business Mailing Address Fax Number:
501-492-3063

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
101 NORTH ROSE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SHERIDAN
Provider Business Practice Location Address State Name:
AR
Provider Business Practice Location Address Postal Code:
72150-2137
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
870-942-0844
Provider Business Practice Location Address Fax Number:
870-942-0846
Provider Enumeration Date:
03/19/2008

Additional Information

Authorized Official

Authorized Official Last Name:
TURNER
Authorized Official First Name:
RULOFF
Authorized Official Middle Name:
P
Authorized Official Title or Position:
PHYSICIAN/OWNER
Authorized Official Telephone Number:
870-942-0844

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X , with the licence number:  E4301 , registered in the state of AR ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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