Provider Demographics
NPI:1508999848
Name:TURNER, GARY T (MD)
Entity Type:Individual
Prefix:
First Name:GARY
Middle Name:T
Last Name:TURNER
Suffix:
Gender:M
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:PO BOX 55310
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35255-5310
Mailing Address - Country:US
Mailing Address - Phone:205-731-9701
Mailing Address - Fax:
Practice Address - Street 1:1530 3RD AVE S
Practice Address - Street 2:SUITE BDB 563
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35294-0012
Practice Address - Country:US
Practice Address - Phone:205-934-9767
Practice Address - Fax:205-934-3993
Is Sole Proprietor?:No
Enumeration Date:2007-03-14
Last Update Date:2011-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL6379174400000X, 207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL000046417Medicaid
AL051104175OtherBCBS
ALP00840907OtherRAILROAD MEDICARE
AL051104173OtherBCBS
AL117323Medicaid
AL051104174OtherBCBS
AL117320Medicaid
AL117322Medicaid
MS08105748Medicaid
AL000046417Medicaid
AL102I048231Medicare PIN
AL051104174OtherBCBS