Provider Demographics
NPI:1881665867
Name:TURNER, JON DOUGLAS (MD)
Entity Type:Individual
Prefix:DR
First Name:JON
Middle Name:DOUGLAS
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 1:1446 BRYSON RD
Mailing Address - Street 2:
Mailing Address - City:ARDMORE
Mailing Address - State:TN
Mailing Address - Zip Code:38449-5228
Mailing Address - Country:US
Mailing Address - Phone:931-468-2102
Mailing Address - Fax:931-468-2103
Practice Address - Street 1:1446 BRYSON RD
Practice Address - Street 2:
Practice Address - City:ARDMORE
Practice Address - State:TN
Practice Address - Zip Code:38449
Practice Address - Country:US
Practice Address - Phone:931-468-2102
Practice Address - Fax:931-468-2103
Is Sole Proprietor?:No
Enumeration Date:2006-01-30
Last Update Date:2018-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL07955207RC0000X
TN21295207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
060037263OtherRAILROAD MEDICARE
AL000031073Medicaid
AL51031073OtherBCBS
C71805Medicare UPIN
25-10172OtherUNITED HEALTHCARE
4036970OtherAETNA
TN0059135OtherBCBS
TN3807631Medicare ID - Type Unspecified
AL000031073Medicare ID - Type Unspecified