Provider Demographics
NPI:1346526803
Name:TURNER, JEFFREY (RPH)
Entity Type:Individual
Prefix:
First Name:JEFFREY
Middle Name:
Last Name:TURNER
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9042 S YORK CT
Mailing Address - Street 2:
Mailing Address - City:OAK CREEK
Mailing Address - State:WI
Mailing Address - Zip Code:53154-3730
Mailing Address - Country:US
Mailing Address - Phone:414-659-3810
Mailing Address - Fax:
Practice Address - Street 1:3109 S KINNICKINNIC AVE
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53207-2935
Practice Address - Country:US
Practice Address - Phone:414-482-3515
Practice Address - Fax:414-482-9680
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-28
Last Update Date:2011-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WIR9925-040183500000X
IA15773183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WIR9925-040OtherWISCONSIN PHARMACY EXAMINING BOARD
IA15773OtherIOWA PHARMACY EXAMINING BOARD