Provider Demographics
NPI:1508883612
Name:TURNBOUGH, VICKIE A (MD)
Entity Type:Individual
Prefix:DR
First Name:VICKIE
Middle Name:A
Last Name:TURNBOUGH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:711 COOK DR
Mailing Address - Street 2:SUITE 110
Mailing Address - City:ATHENS
Mailing Address - State:TN
Mailing Address - Zip Code:37303-3486
Mailing Address - Country:US
Mailing Address - Phone:423-746-0122
Mailing Address - Fax:423-745-9456
Practice Address - Street 1:711 COOK DR
Practice Address - Street 2:SUITE 110
Practice Address - City:ATHENS
Practice Address - State:TN
Practice Address - Zip Code:37303-3486
Practice Address - Country:US
Practice Address - Phone:423-746-0122
Practice Address - Fax:423-745-9456
Is Sole Proprietor?:No
Enumeration Date:2006-07-16
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD0000025849207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3098590Medicaid
TN110230920OtherMEDICARE RR
TN4020111OtherBCBS
TN4020111OtherBCBS
TN3098590Medicaid