Provider Demographics
NPI: | 1750483822 |
---|---|
Name: | TURNBO, JAMES KYLE (MD PSC) |
Entity Type: | Individual |
Prefix: | |
First Name: | JAMES |
Middle Name: | KYLE |
Last Name: | TURNBO |
Suffix: | |
Gender: | M |
Credentials: | MD PSC |
Other - Prefix: | |
Other - First Name: | |
Other - Middle Name: | |
Other - Last Name: | |
Other - Suffix: | |
Other - Last Name Type: | |
Other - Credentials: | |
Mailing Address - Street 1: | 2331 NEW HOLT RD |
Mailing Address - Street 2: | |
Mailing Address - City: | PADUCAH |
Mailing Address - State: | KY |
Mailing Address - Zip Code: | 42001-7404 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 270-441-4777 |
Mailing Address - Fax: | 270-441-4780 |
Practice Address - Street 1: | 2331 NEW HOLT RD |
Practice Address - Street 2: | |
Practice Address - City: | PADUCAH |
Practice Address - State: | KY |
Practice Address - Zip Code: | 42001-7404 |
Practice Address - Country: | US |
Practice Address - Phone: | 270-441-4777 |
Practice Address - Fax: | 270-441-4780 |
Is Sole Proprietor?: | No |
Enumeration Date: | 2006-09-01 |
Last Update Date: | 2023-07-06 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
KY | 35898 | 207Q00000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 207Q00000X | Allopathic & Osteopathic Physicians | Family Medicine |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
KY | 000000077491 | Other | BCBS PIN # |
KY | 65933590 | Medicaid | |
KY | 435934 | Other | HEALTHLINK ID NUMBER |
KY | 64024714 | Medicaid | |
KY | 435934 | Other | HEALTHLINK ID NUMBER |
KY | 1836401 | Medicare ID - Type Unspecified |