Provider Demographics
NPI:1245292317
Name:TURNAGE, STEPHANIE N (MD)
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:N
Last Name:TURNAGE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1462 MONTREAL RD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:TUCKER
Mailing Address - State:GA
Mailing Address - Zip Code:30084-6929
Mailing Address - Country:US
Mailing Address - Phone:770-414-5611
Mailing Address - Fax:770-414-5612
Practice Address - Street 1:1462 MONTREAL RD
Practice Address - Street 2:SUITE 201
Practice Address - City:TUCKER
Practice Address - State:GA
Practice Address - Zip Code:30084-6929
Practice Address - Country:US
Practice Address - Phone:770-414-5611
Practice Address - Fax:770-414-5612
Is Sole Proprietor?:No
Enumeration Date:2006-04-04
Last Update Date:2008-07-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA057199207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA758713451BMedicaid
GA11SCHDGMedicare PIN
GAI54578Medicare UPIN