Provider Demographics
NPI:1124185863
Name:TURNER, MARK F (DC)
Entity Type:Individual
Prefix:
First Name:MARK
Middle Name:F
Last Name:TURNER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1018 S MAIN ST
Mailing Address - Street 2:SUITE A
Mailing Address - City:MILTON FREEWATER
Mailing Address - State:OR
Mailing Address - Zip Code:97862-1534
Mailing Address - Country:US
Mailing Address - Phone:541-938-4140
Mailing Address - Fax:541-938-4140
Practice Address - Street 1:1018 S MAIN ST
Practice Address - Street 2:SUITE A
Practice Address - City:MILTON FREEWATER
Practice Address - State:OR
Practice Address - Zip Code:97862-1534
Practice Address - Country:US
Practice Address - Phone:541-938-4140
Practice Address - Fax:541-938-4140
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR1355111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
ORR0000QGBLHMedicare ID - Type UnspecifiedMEDICARE B