Provider Demographics
NPI:1811962541
Name:TURNER, JAY D (AUD, CCC-A)
Entity type:Individual
Prefix:
First Name:JAY
Middle Name:D
Last Name:TURNER
Suffix:
Gender:M
Credentials:AUD, CCC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3303 N UNIVERSITY AVE
Mailing Address - Street 2:
Mailing Address - City:PROVO
Mailing Address - State:UT
Mailing Address - Zip Code:84604-4438
Mailing Address - Country:US
Mailing Address - Phone:801-373-7438
Mailing Address - Fax:801-373-7486
Practice Address - Street 1:3303 N UNIVERSITY AVE
Practice Address - Street 2:
Practice Address - City:PROVO
Practice Address - State:UT
Practice Address - Zip Code:84604-4438
Practice Address - Country:US
Practice Address - Phone:801-373-7438
Practice Address - Fax:801-373-7486
Is Sole Proprietor?:No
Enumeration Date:2006-02-17
Last Update Date:2017-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT9818436-4101231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT1447275946Medicaid
UTU000095681Medicare PIN
UT1447275946Medicaid
WAP00026836OtherRAIL ROAD MEDICARE
WAGAB20908Medicare PIN
WA144763OtherL&I