Provider Demographics
NPI:1962483644
Name:TURNER, WILLIAM BOMAR III (MD)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:BOMAR
Last Name:TURNER
Suffix:III
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 1:1112 GRACIE PL
Mailing Address - Street 2:
Mailing Address - City:GOLDSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27534-2260
Mailing Address - Country:US
Mailing Address - Phone:919-735-1635
Mailing Address - Fax:919-735-6699
Practice Address - Street 1:1112 GRACIE PL
Practice Address - Street 2:
Practice Address - City:GOLDSBORO
Practice Address - State:NC
Practice Address - Zip Code:27534-2260
Practice Address - Country:US
Practice Address - Phone:919-735-1635
Practice Address - Fax:919-735-6699
Is Sole Proprietor?:No
Enumeration Date:2005-11-09
Last Update Date:2015-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC29048208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8984105Medicaid
211087Medicare ID - Type Unspecified
NC8984105Medicaid