Provider Demographics
NPI:1942616248
Name:TURNER, BARRY
Entity Type:Individual
Prefix:MR
First Name:BARRY
Middle Name:
Last Name:TURNER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:G1035 E CARPENTER RD
Mailing Address - Street 2:
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48505-2208
Mailing Address - Country:US
Mailing Address - Phone:810-787-8311
Mailing Address - Fax:810-785-0707
Practice Address - Street 1:4058 N LINDEN RD
Practice Address - Street 2:SUITE C
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48504-1381
Practice Address - Country:US
Practice Address - Phone:810-407-7705
Practice Address - Fax:810-407-7711
Is Sole Proprietor?:No
Enumeration Date:2014-07-08
Last Update Date:2014-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIL10201172A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172A00000XOther Service ProvidersDriver