Provider Demographics
NPI:1548403546
Name:TURNER, GARY W (MD)
Entity Type:Individual
Prefix:MR
First Name:GARY
Middle Name:W
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 40
Mailing Address - Street 2:
Mailing Address - City:WHITESBURG
Mailing Address - State:KY
Mailing Address - Zip Code:41858-0040
Mailing Address - Country:US
Mailing Address - Phone:606-633-4823
Mailing Address - Fax:606-633-1874
Practice Address - Street 1:72 BUCKHORN CLINIC RD
Practice Address - Street 2:
Practice Address - City:BUCKHORN
Practice Address - State:KY
Practice Address - Zip Code:41721-8936
Practice Address - Country:US
Practice Address - Phone:606-398-7141
Practice Address - Fax:606-398-7136
Is Sole Proprietor?:No
Enumeration Date:2009-04-07
Last Update Date:2013-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY42300207Q00000X, 207QH0002X
OH092565207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207QH0002XAllopathic & Osteopathic PhysiciansFamily MedicineHospice and Palliative Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100079460Medicaid
KY0290514Medicare PIN