Provider Demographics
NPI:1871980110
Name:TURNER MEDICAL GROUP
Entity type:Organization
Organization Name:TURNER MEDICAL GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHAD
Authorized Official - Middle Name:CHRISTOPHER
Authorized Official - Last Name:TURNER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:304-776-1611
Mailing Address - Street 1:816 CROSS LANES DR
Mailing Address - Street 2:
Mailing Address - City:CROSS LANES
Mailing Address - State:WV
Mailing Address - Zip Code:25313-1334
Mailing Address - Country:US
Mailing Address - Phone:304-776-1611
Mailing Address - Fax:304-776-0116
Practice Address - Street 1:816 CROSS LANES DR
Practice Address - Street 2:
Practice Address - City:CROSS LANES
Practice Address - State:WV
Practice Address - Zip Code:25313-1334
Practice Address - Country:US
Practice Address - Phone:304-776-1611
Practice Address - Fax:304-776-0116
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-24
Last Update Date:2015-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV22110261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV3810004529Medicaid
WVI41860Medicare UPIN