Provider Demographics
NPI:1710075478
Name:EARL, DAVID THURN (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:THURN
Last Name:EARL
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 1:1550 S PIONEER WAY
Mailing Address - Street 2:SUITE 200
Mailing Address - City:MOSES LAKE
Mailing Address - State:WA
Mailing Address - Zip Code:98837-4613
Mailing Address - Country:US
Mailing Address - Phone:509-765-1538
Mailing Address - Fax:509-765-7508
Practice Address - Street 1:1550 S PIONEER WAY
Practice Address - Street 2:SUITE 200
Practice Address - City:MOSES LAKE
Practice Address - State:WA
Practice Address - Zip Code:98837-4613
Practice Address - Country:US
Practice Address - Phone:509-765-1538
Practice Address - Fax:509-765-7508
Is Sole Proprietor?:No
Enumeration Date:2006-10-10
Last Update Date:2013-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00028611207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1110337Medicaid
WA43758OtherDEPT OF LABOR & INDUSTRIE
WA1110337Medicaid
WAE98618Medicare UPIN