Provider Demographics
NPI:1285630715
Name:TURNER, GERALD (MD)
Entity Type:Individual
Prefix:DR
First Name:GERALD
Middle Name:
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 1:56 DUTCH LN
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:MS
Mailing Address - Zip Code:39702-5500
Mailing Address - Country:US
Mailing Address - Phone:662-329-3808
Mailing Address - Fax:662-329-3873
Practice Address - Street 1:56 DUTCH LN
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:MS
Practice Address - Zip Code:39702-5500
Practice Address - Country:US
Practice Address - Phone:662-329-3808
Practice Address - Fax:662-329-3873
Is Sole Proprietor?:No
Enumeration Date:2005-06-21
Last Update Date:2011-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS16727207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS00010457Medicaid
MSE61369Medicare UPIN
MS080001702Medicare PIN