Provider Demographics
NPI:1598291254
Name:TURNER, WILLIAM RANDALL JR (MD)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:RANDALL
Last Name:TURNER
Suffix:JR
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 1:1705 MAIN AVE SW STE B
Mailing Address - Street 2:
Mailing Address - City:CULLMAN
Mailing Address - State:AL
Mailing Address - Zip Code:35055-7207
Mailing Address - Country:US
Mailing Address - Phone:256-965-0340
Mailing Address - Fax:256-965-0341
Practice Address - Street 1:1705 MAIN AVE SW STE B
Practice Address - Street 2:
Practice Address - City:CULLMAN
Practice Address - State:AL
Practice Address - Zip Code:35055-7207
Practice Address - Country:US
Practice Address - Phone:256-965-0340
Practice Address - Fax:256-965-0341
Is Sole Proprietor?:No
Enumeration Date:2017-05-02
Last Update Date:2023-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL37447207Q00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL249004Medicaid