Provider Demographics
NPI:1801864335
Name:TURNER, THANE NOLAN (MD)
Entity Type:Individual
Prefix:DR
First Name:THANE
Middle Name:NOLAN
Last Name:TURNER
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 1:3 WASHINGTON ST
Mailing Address - Street 2:STE 220
Mailing Address - City:NORTH EASTON
Mailing Address - State:MA
Mailing Address - Zip Code:02356-1034
Mailing Address - Country:US
Mailing Address - Phone:508-230-0155
Mailing Address - Fax:
Practice Address - Street 1:3 WASHINGTON ST STE 220
Practice Address - Street 2:
Practice Address - City:NORTH EASTON
Practice Address - State:MA
Practice Address - Zip Code:02356
Practice Address - Country:US
Practice Address - Phone:508-230-0155
Practice Address - Fax:508-230-0145
Is Sole Proprietor?:No
Enumeration Date:2006-03-10
Last Update Date:2018-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA273026207Q00000X
PAMD058167L207VX0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207VX0000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyObstetrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA110126845AMedicaid
PA1553616OtherUNITEDHEALTHCARE
PA541872OtherAETNA
PA440550OtherFIRST PRIORITY HEALTH
PA001741OtherFIRST PRIORITY HEALTH
PA186686OtherHIGHMARK BLUE SHIELD
PAG24670OtherHEALTHAMERICA
PA001741OtherFIRST PRIORITY HEALTH
G24670Medicare UPIN
PA0015614740004Medicaid