Provider Demographics
NPI:1871589473
Name:TURNER, LARRY L (MD)
Entity type:Individual
Prefix:DR
First Name:LARRY
Middle Name:L
Last Name:TURNER
Suffix:
Gender:M
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:PO BOX 176
Mailing Address - Street 2:
Mailing Address - City:CARTHAGE
Mailing Address - State:TN
Mailing Address - Zip Code:37030-0176
Mailing Address - Country:US
Mailing Address - Phone:615-735-0700
Mailing Address - Fax:615-735-5480
Practice Address - Street 1:133 HOSPITAL DR
Practice Address - Street 2:SUITE 500
Practice Address - City:CARTHAGE
Practice Address - State:TN
Practice Address - Zip Code:37030-4004
Practice Address - Country:US
Practice Address - Phone:615-735-0700
Practice Address - Fax:615-735-5480
Is Sole Proprietor?:No
Enumeration Date:2005-09-20
Last Update Date:2014-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN11288208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNQ000999Medicaid
TN3166797Medicare PIN
TNQ000999Medicaid