Provider Demographics
NPI:1841514031
Name:TURNER, KEITH PATRICK (PAC)
Entity type:Individual
Prefix:MR
First Name:KEITH
Middle Name:PATRICK
Last Name:TURNER
Suffix:
Gender:M
Credentials:PAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:225 ADLEY WAY
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29607-6511
Mailing Address - Country:US
Mailing Address - Phone:864-987-9747
Mailing Address - Fax:864-987-9770
Practice Address - Street 1:225 ADLEY WAY
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29607-6511
Practice Address - Country:US
Practice Address - Phone:864-987-9747
Practice Address - Fax:864-987-9770
Is Sole Proprietor?:No
Enumeration Date:2010-03-17
Last Update Date:2020-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCPA1498363AS0400X, 363A00000X
FLPA9106500363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical