Provider Demographics
NPI:1780613109
Name:TURNER, RYAN RAY (MD)
Entity type:Individual
Prefix:
First Name:RYAN
Middle Name:RAY
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:PO BOX 1330
Mailing Address - Street 2:
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73070-1330
Mailing Address - Country:US
Mailing Address - Phone:405-485-9321
Mailing Address - Fax:405-485-3154
Practice Address - Street 1:1019 N COUNCIL AVE
Practice Address - Street 2:SUITE 1
Practice Address - City:BLANCHARD
Practice Address - State:OK
Practice Address - Zip Code:73010-8045
Practice Address - Country:US
Practice Address - Phone:405-515-0360
Practice Address - Fax:405-307-5596
Is Sole Proprietor?:No
Enumeration Date:2006-06-30
Last Update Date:2021-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK22437207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200034330BMedicaid
OKOK401873Medicare PIN
OK200034330BMedicaid