Provider Demographics
NPI:1396821336
Name:TURNBAUGH SURGICAL ASSOCIATES, INC.
Entity Type:Organization
Organization Name:TURNBAUGH SURGICAL ASSOCIATES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JEANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHWALLER
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:573-230-3631
Mailing Address - Street 1:1616 SOUTHRIDGE DR STE 202
Mailing Address - Street 2:
Mailing Address - City:JEFFERSON CITY
Mailing Address - State:MO
Mailing Address - Zip Code:65109-5677
Mailing Address - Country:US
Mailing Address - Phone:573-636-5450
Mailing Address - Fax:573-636-7906
Practice Address - Street 1:1616 SOUTHRIDGE DR STE 202
Practice Address - Street 2:
Practice Address - City:JEFFERSON CITY
Practice Address - State:MO
Practice Address - Zip Code:65109-5677
Practice Address - Country:US
Practice Address - Phone:573-636-5450
Practice Address - Fax:573-636-7906
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-31
Last Update Date:2019-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOR9C84207X00000X
332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
No332B00000XSuppliersDurable Medical Equipment & Medical SuppliesGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO1269770001Medicare NSC