Provider Demographics
NPI: | 1821276916 |
---|---|
Name: | TURNER, ALEXANDRA P (MD) |
Entity Type: | Individual |
Prefix: | DR |
First Name: | ALEXANDRA |
Middle Name: | P |
Last Name: | TURNER |
Suffix: | |
Gender: | F |
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: | PO BOX 781076 |
Mailing Address - Street 2: | |
Mailing Address - City: | DETROIT |
Mailing Address - State: | MI |
Mailing Address - Zip Code: | 48278-1076 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 317-528-4800 |
Mailing Address - Fax: | 317-865-1479 |
Practice Address - Street 1: | 1704 LAFAYETTE RD STE 2 |
Practice Address - Street 2: | |
Practice Address - City: | CRAWFORDSVILLE |
Practice Address - State: | IN |
Practice Address - Zip Code: | 47933-1071 |
Practice Address - Country: | US |
Practice Address - Phone: | 765-359-2088 |
Practice Address - Fax: | 765-359-2237 |
Is Sole Proprietor?: | No |
Enumeration Date: | 2008-01-31 |
Last Update Date: | 2022-07-21 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
FL | ME121085 | 204F00000X |
GA | 000722 | 208600000X |
IN | 01072371A | 208600000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 208600000X | Allopathic & Osteopathic Physicians | Surgery | |
No | 204F00000X | Allopathic & Osteopathic Physicians | Transplant Surgery |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
IN | 201182500 | Medicaid | |
IN | 233690019 | Medicare PIN | |
IN | P01284111 | Medicare PIN |