Provider Demographics
NPI:1366525271
Name:TURNER MEDICAL CLINIC
Entity type:Organization
Organization Name:TURNER MEDICAL CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:P
Authorized Official - Last Name:TURNER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:225-869-3838
Mailing Address - Street 1:PO BOX 509
Mailing Address - Street 2:
Mailing Address - City:LUTCHER
Mailing Address - State:LA
Mailing Address - Zip Code:70071-0509
Mailing Address - Country:US
Mailing Address - Phone:225-869-3838
Mailing Address - Fax:225-869-9649
Practice Address - Street 1:2468 LOUISIANA AVE
Practice Address - Street 2:
Practice Address - City:LUTCHER
Practice Address - State:LA
Practice Address - Zip Code:70071-0509
Practice Address - Country:US
Practice Address - Phone:225-869-3838
Practice Address - Fax:225-869-9649
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-23
Last Update Date:2007-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1940101Medicaid
LAB63901Medicare UPIN
LA57654Medicare PIN