Provider Demographics
NPI:1255339008
Name:TURNER, KEITH S (MD)
Entity type:Individual
Prefix:DR
First Name:KEITH
Middle Name:S
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 1:701 OSTRUM ST
Mailing Address - Street 2:SUITE 604
Mailing Address - City:FOUNTAIN HILL
Mailing Address - State:PA
Mailing Address - Zip Code:18015-1155
Mailing Address - Country:US
Mailing Address - Phone:610-866-3900
Mailing Address - Fax:610-866-8140
Practice Address - Street 1:701 OSTRUM ST
Practice Address - Street 2:SUITE 604
Practice Address - City:FOUNTAIN HILL
Practice Address - State:PA
Practice Address - Zip Code:18015-1155
Practice Address - Country:US
Practice Address - Phone:610-866-3900
Practice Address - Fax:610-866-8140
Is Sole Proprietor?:No
Enumeration Date:2005-07-13
Last Update Date:2008-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD019604-E174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAMD019604EOtherPA LICENSE
PATU069613Medicare PIN