Provider Demographics
NPI:1336552348
Name:TURBEVILLE, RICHARD DEAN JR (MD)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:DEAN
Last Name:TURBEVILLE
Suffix:JR
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 1:207 CARTER ST
Mailing Address - Street 2:
Mailing Address - City:BERRYVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72616-4303
Mailing Address - Country:US
Mailing Address - Phone:870-423-6661
Mailing Address - Fax:
Practice Address - Street 1:207 CARTER ST
Practice Address - Street 2:
Practice Address - City:BERRYVILLE
Practice Address - State:AR
Practice Address - Zip Code:72616-4303
Practice Address - Country:US
Practice Address - Phone:870-423-6661
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-06-06
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01075634A208M00000X
390200000X
ARE-10570207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN201239290Medicaid
INP01720531OtherRAILROAD MEDICARE
IN000001041318OtherANTHEM
IN256480053Medicare PIN