Provider Demographics
NPI:1952300295
Name:TURNER, KEVIN WILLIAM (MD)
Entity Type:Individual
Prefix:DR
First Name:KEVIN
Middle Name:WILLIAM
Last Name:TURNER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:19420 N 59TH AVE
Mailing Address - Street 2:BUILDING H, SUITE 800
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85308-6817
Mailing Address - Country:US
Mailing Address - Phone:602-889-7365
Mailing Address - Fax:602-993-1745
Practice Address - Street 1:19420 NORTH 59TH AVENUE
Practice Address - Street 2:BUILDING H, SUITE 800
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85308
Practice Address - Country:US
Practice Address - Phone:602-889-7365
Practice Address - Fax:602-993-1745
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-19
Last Update Date:2023-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ7046960001332B00000X
AZ7045160001332B00000X
AZ7047150001332B00000X
AZ7209350001332B00000X
AZ7629170001332B00000X
AZ7034950001332B00000X
AZ7057360001332B00000X
AZ8220410001332B00000X
AZ7939960001332B00000X
AZ22397207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZF80762Medicare UPIN
AZ24466Medicare ID - Type Unspecified