Provider Demographics
NPI:1508867060
Name:TURNER, KEVIN MARCELL (DO)
Entity Type:Individual
Prefix:MR
First Name:KEVIN
Middle Name:MARCELL
Last Name:TURNER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:227 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:FESTUS
Mailing Address - State:MO
Mailing Address - Zip Code:63028-1952
Mailing Address - Country:US
Mailing Address - Phone:636-931-2700
Mailing Address - Fax:636-931-5304
Practice Address - Street 1:4 HICKORY RIDGE RD
Practice Address - Street 2:SUITE 600
Practice Address - City:HILLSBORO
Practice Address - State:MO
Practice Address - Zip Code:63050-5100
Practice Address - Country:US
Practice Address - Phone:636-481-6040
Practice Address - Fax:636-797-5633
Is Sole Proprietor?:No
Enumeration Date:2005-08-09
Last Update Date:2016-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOR4N90207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO242855708Medicaid
MO242855724Medicaid
MOE66052Medicare ID - Type Unspecified
MO242855724Medicaid