Provider Demographics
NPI:1952877318
Name:TURNER, TY (PHARMD)
Entity Type:Individual
Prefix:
First Name:TY
Middle Name:
Last Name:TURNER
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3929 WALNUT ST APT 2
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64111-2636
Mailing Address - Country:US
Mailing Address - Phone:316-680-7532
Mailing Address - Fax:
Practice Address - Street 1:2900 S 4TH ST
Practice Address - Street 2:
Practice Address - City:LEAVENWORTH
Practice Address - State:KS
Practice Address - Zip Code:66048-5002
Practice Address - Country:US
Practice Address - Phone:913-651-2027
Practice Address - Fax:913-651-2008
Is Sole Proprietor?:No
Enumeration Date:2018-10-23
Last Update Date:2018-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2017030951183500000X
KS1-103179183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist