Provider Demographics
NPI:1609871581
Name:TURNER WHITLEY & MORTON INTERNAL MEDICINE PSC
Entity Type:Organization
Organization Name:TURNER WHITLEY & MORTON INTERNAL MEDICINE PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:KATHY
Authorized Official - Middle Name:
Authorized Official - Last Name:SHEPHERD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:606-528-4481
Mailing Address - Street 1:1419 CUMBERLAND FALLS HWY
Mailing Address - Street 2:
Mailing Address - City:CORBIN
Mailing Address - State:KY
Mailing Address - Zip Code:40701-2722
Mailing Address - Country:US
Mailing Address - Phone:606-528-4481
Mailing Address - Fax:606-528-2857
Practice Address - Street 1:1419 CUMBERLAND FALLS HWY
Practice Address - Street 2:
Practice Address - City:CORBIN
Practice Address - State:KY
Practice Address - Zip Code:40701-2722
Practice Address - Country:US
Practice Address - Phone:606-528-4481
Practice Address - Fax:606-528-2857
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-16
Last Update Date:2012-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY20474,23298,32248207R00000X
KY363AM0700X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedicalGroup - Multi-Specialty
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY65936817Medicaid
KY2995Medicare PIN