Provider Demographics
NPI:1114124021
Name:TURPEN, KLARK BENNETT (MD)
Entity Type:Individual
Prefix:DR
First Name:KLARK
Middle Name:BENNETT
Last Name:TURPEN
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 1:216 W WALNUT ST
Mailing Address - Street 2:STE A
Mailing Address - City:DANVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40422-1832
Mailing Address - Country:US
Mailing Address - Phone:270-651-3729
Mailing Address - Fax:270-651-1899
Practice Address - Street 1:1301 N RACE ST
Practice Address - Street 2:
Practice Address - City:GLASGOW
Practice Address - State:KY
Practice Address - Zip Code:42141-3454
Practice Address - Country:US
Practice Address - Phone:270-651-3729
Practice Address - Fax:270-651-1899
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-03
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY44304207RS0012X
FLTRN11519207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100193400Medicaid