Provider Demographics
NPI:1659534303
Name:TURKSON MEDICAL CENTRE LLC
Entity Type:Organization
Organization Name:TURKSON MEDICAL CENTRE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:KOFI
Authorized Official - Middle Name:B
Authorized Official - Last Name:TURKSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:702-418-1690
Mailing Address - Street 1:PO BOX 400608
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89140-0608
Mailing Address - Country:US
Mailing Address - Phone:702-418-1690
Mailing Address - Fax:
Practice Address - Street 1:8945 W POST RD
Practice Address - Street 2:SUITE 100
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89148-2431
Practice Address - Country:US
Practice Address - Phone:702-418-1690
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-02
Last Update Date:2014-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV10409207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV100500913Medicaid
NV100500913Medicaid