Provider Demographics
NPI:1245221522
Name:TURNER, JAMES A (DO)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:A
Last Name:TURNER
Suffix:
Gender:M
Credentials:DO
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 2505
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46206-2505
Mailing Address - Country:US
Mailing Address - Phone:812-238-7783
Mailing Address - Fax:812-238-4506
Practice Address - Street 1:410 N 2ND ST
Practice Address - Street 2:
Practice Address - City:MARSHALL
Practice Address - State:IL
Practice Address - Zip Code:62441-1010
Practice Address - Country:US
Practice Address - Phone:217-826-2361
Practice Address - Fax:217-826-2366
Is Sole Proprietor?:No
Enumeration Date:2005-11-04
Last Update Date:2011-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036-078289207Q00000X
IN02000978207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL070007705OtherRR MEDICARE
IL036078289Medicaid
IN100252330Medicaid
IN254390CMedicare PIN
E31308Medicare UPIN
IL036078289Medicaid
ILK39170Medicare PIN
IN100252330Medicaid
INM400032095Medicare PIN
IN130910QMedicare PIN
IN252060KMedicare PIN