Provider Demographics
NPI:1952369423
Name:TURCOT, DIANE B (MD)
Entity Type:Individual
Prefix:
First Name:DIANE
Middle Name:B
Last Name:TURCOT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:660 MASON RIDGE CENTER DR STE 300
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63141-8512
Mailing Address - Country:US
Mailing Address - Phone:314-448-3791
Mailing Address - Fax:314-996-7658
Practice Address - Street 1:4600 MEMORIAL DR STE W1
Practice Address - Street 2:
Practice Address - City:BELLEVILLE
Practice Address - State:IL
Practice Address - Zip Code:62226-5359
Practice Address - Country:US
Practice Address - Phone:618-233-3066
Practice Address - Fax:618-233-3180
Is Sole Proprietor?:No
Enumeration Date:2006-05-03
Last Update Date:2024-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEMD26834207RC0000X
IL036169870207RC0000X
PAMD464704207RC0000X
MA216952207RC0000X
MEEL231005207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30204377Medicaid
NHP00964186OtherRAILROAD MEDICARE
MAP00964186OtherRAILROAD MEDICARE
MA2115875Medicaid
NHP00964186OtherRAILROAD MEDICARE
MA2115875Medicaid