Provider Demographics
NPI:1295864874
Name:HOUSTON, TURNER ORLAN JR (DPM)
Entity Type:Individual
Prefix:DR
First Name:TURNER
Middle Name:ORLAN
Last Name:HOUSTON
Suffix:JR
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:648 AQUATIC DR
Mailing Address - Street 2:
Mailing Address - City:ATLANTIC BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32233-3841
Mailing Address - Country:US
Mailing Address - Phone:904-246-2164
Mailing Address - Fax:
Practice Address - Street 1:648 AQUATIC DR
Practice Address - Street 2:
Practice Address - City:ATLANTIC BEACH
Practice Address - State:FL
Practice Address - Zip Code:32233-3841
Practice Address - Country:US
Practice Address - Phone:904-246-2164
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-02
Last Update Date:2013-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPO 850213EP1101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213EP1101XPodiatric Medicine & Surgery Service ProvidersPodiatristPrimary Podiatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL406480161Medicare ID - Type UnspecifiedRAILROAD MEDICARE
FL87351Medicare ID - Type Unspecified
T95145Medicare UPIN