Provider Demographics
NPI:1538642475
Name:TURNER LEGACY HEALTHCARE LLC
Entity Type:Organization
Organization Name:TURNER LEGACY HEALTHCARE LLC
Other - Org Name:MABLETON URGENT CARE AND OCCUPATIONAL MEDICINE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:EDDIE
Authorized Official - Middle Name:JOE
Authorized Official - Last Name:TURNER
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:770-485-3458
Mailing Address - Street 1:4855 FLOYD RD SW STE 104
Mailing Address - Street 2:
Mailing Address - City:MABLETON
Mailing Address - State:GA
Mailing Address - Zip Code:30126-1323
Mailing Address - Country:US
Mailing Address - Phone:770-485-3458
Mailing Address - Fax:678-398-9198
Practice Address - Street 1:4855 FLOYD RD SW STE 104
Practice Address - Street 2:
Practice Address - City:MABLETON
Practice Address - State:GA
Practice Address - Zip Code:30126-1323
Practice Address - Country:US
Practice Address - Phone:770-485-3458
Practice Address - Fax:678-398-9198
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-06
Last Update Date:2019-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
208D00000X
GA65910261QX0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QX0100XAmbulatory Health Care FacilitiesClinic/CenterOccupational Medicine
No208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty