1083712392 NPI number — MRS. JULIE R TURNER PT

Table of content: MRS. JULIE R TURNER PT (NPI 1083712392)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1083712392 NPI number — MRS. JULIE R TURNER PT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
TURNER
Provider First Name:
JULIE
Provider Middle Name:
R
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
PT
Provider Gender Code:
F

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:
1083712392
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/26/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
203 DAWKINS DR
Provider Second Line Business Mailing Address:
SUITE C
Provider Business Mailing Address City Name:
LEWISBURG
Provider Business Mailing Address State Name:
WV
Provider Business Mailing Address Postal Code:
24901-9674
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
304-645-9797
Provider Business Mailing Address Fax Number:
304-645-9799

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
203 DAWKINS DR
Provider Second Line Business Practice Location Address:
SUITE C
Provider Business Practice Location Address City Name:
LEWISBURG
Provider Business Practice Location Address State Name:
WV
Provider Business Practice Location Address Postal Code:
24901-9674
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
304-645-9797
Provider Business Practice Location Address Fax Number:
304-645-9799
Provider Enumeration Date:
09/20/2006

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: 225100000X , with the licence number:  1116 , registered in the state of WV ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 225100000X , with the licence number: 2305004851 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 7305210000 , issued by the state of ( WV ) . This identifiers is of the category "MEDICAID".




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