Provider Demographics
NPI:1982720322
Name:SANDY D TURNER DO INCORPORATED
Entity Type:Organization
Organization Name:SANDY D TURNER DO INCORPORATED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:SANDY
Authorized Official - Middle Name:DANIELLE
Authorized Official - Last Name:TURNER
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:937-325-8519
Mailing Address - Street 1:1835 E HIGH ST
Mailing Address - Street 2:SUITE 4
Mailing Address - City:SPRINGFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:45505-5210
Mailing Address - Country:US
Mailing Address - Phone:937-325-8519
Mailing Address - Fax:937-325-8529
Practice Address - Street 1:1835 E HIGH ST
Practice Address - Street 2:SUITE 4
Practice Address - City:SPRINGFIELD
Practice Address - State:OH
Practice Address - Zip Code:45505-5210
Practice Address - Country:US
Practice Address - Phone:937-325-8519
Practice Address - Fax:937-325-8529
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-21
Last Update Date:2008-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34007818207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2446482Medicaid
OHDE2398OtherRAILROAD MEDICARE
OH9344071Medicare PIN
OHDE2398OtherRAILROAD MEDICARE