Provider Demographics
NPI:1295856425
Name:DRS. TURNER, ELLEDGE, & FAVROT, P.C.
Entity Type:Organization
Organization Name:DRS. TURNER, ELLEDGE, & FAVROT, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GARY
Authorized Official - Middle Name:T
Authorized Official - Last Name:TURNER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:205-591-6570
Mailing Address - Street 1:840 MONTCLAIR RD
Mailing Address - Street 2:SUITE 218
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35213-1920
Mailing Address - Country:US
Mailing Address - Phone:205-591-6570
Mailing Address - Fax:
Practice Address - Street 1:840 MONTCLAIR RD
Practice Address - Street 2:SUITE 218
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35213-1920
Practice Address - Country:US
Practice Address - Phone:205-591-6570
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALMD.12962174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALD839Medicare ID - Type UnspecifiedMEDICARE GRP #