Provider Demographics
NPI:1447209671
Name:TURNER, JACQUELINE SUE (MD)
Entity Type:Individual
Prefix:DR
First Name:JACQUELINE
Middle Name:SUE
Last Name:TURNER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1110 HIGHLANDS PLAZA DR E STE 280
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63110-1351
Mailing Address - Country:US
Mailing Address - Phone:314-286-2620
Mailing Address - Fax:
Practice Address - Street 1:1110 HIGHLANDS PLAZA DR E
Practice Address - Street 2:SUITE 280
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63110-1350
Practice Address - Country:US
Practice Address - Phone:314-286-2620
Practice Address - Fax:314-286-2621
Is Sole Proprietor?:No
Enumeration Date:2006-05-06
Last Update Date:2021-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOR7G59207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO207837626Medicaid
MO107334OtherBLUE CROSS/BLUE SHIELD
25143OtherGROUP HEALTH PLAN
0700396OtherUNITED HEALTHCARE
194769OtherHEALTHLINK
MOA12704Medicare UPIN
MO000094854Medicare ID - Type Unspecified