Provider Demographics
NPI:1356866552
Name:WELBORN, TURNER ALAN
Entity type:Individual
Prefix:
First Name:TURNER
Middle Name:ALAN
Last Name:WELBORN
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 1:903 CONCORD AVE
Mailing Address - Street 2:
Mailing Address - City:ANDERSON
Mailing Address - State:SC
Mailing Address - Zip Code:29621-1907
Mailing Address - Country:US
Mailing Address - Phone:864-934-1812
Mailing Address - Fax:
Practice Address - Street 1:2003 E GREENVILLE ST
Practice Address - Street 2:
Practice Address - City:ANDERSON
Practice Address - State:SC
Practice Address - Zip Code:29621-1529
Practice Address - Country:US
Practice Address - Phone:864-760-6162
Practice Address - Fax:864-760-6163
Is Sole Proprietor?:No
Enumeration Date:2017-08-08
Last Update Date:2017-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC37296183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist