Provider Demographics
NPI:1851562706
Name:TURNER MEDICAL CLINIC INC
Entity Type:Organization
Organization Name:TURNER MEDICAL CLINIC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RULOFF
Authorized Official - Middle Name:P
Authorized Official - Last Name:TURNER
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:870-942-0844
Mailing Address - Street 1:P.O. BOX 2427
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROAD
Mailing Address - State:AR
Mailing Address - Zip Code:72203-2427
Mailing Address - Country:US
Mailing Address - Phone:501-375-6511
Mailing Address - Fax:501-492-3063
Practice Address - Street 1:101 NORTH ROSE
Practice Address - Street 2:
Practice Address - City:SHERIDAN
Practice Address - State:AR
Practice Address - Zip Code:72150-2137
Practice Address - Country:US
Practice Address - Phone:870-942-0844
Practice Address - Fax:870-942-0846
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-19
Last Update Date:2010-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE4301207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ARI09727Medicare UPIN
AR5F245Medicare PIN