Basic Information
| Provider Information | |||||||||
| NPI: | 1245221522 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | TURNER | ||||||||
| FirstName: | JAMES | ||||||||
| MiddleName: | A | ||||||||
| NamePrefix: | |||||||||
| NameSuffix: | |||||||||
| Credential: | DO | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 2505 | ||||||||
| Address2: | |||||||||
| City: | INDIANAPOLIS | ||||||||
| State: | IN | ||||||||
| PostalCode: | 462062505 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8122387783 | ||||||||
| FaxNumber: | 8122384506 | ||||||||
| Practice Location | |||||||||
| Address1: | 410 N 2ND ST | ||||||||
| Address2: | |||||||||
| City: | MARSHALL | ||||||||
| State: | IL | ||||||||
| PostalCode: | 624411010 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2178262361 | ||||||||
| FaxNumber: | 2178262366 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/04/2005 | ||||||||
| LastUpdateDate: | 01/21/2011 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 036-078289 | IL | Y | Allopathic & Osteopathic Physicians | Family Medicine | 207Q00000X | 02000978 | IN | N | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | 070007705 | 01 | IL | RR MEDICARE | OTHER | 036078289 | 05 | IL | MEDICAID | 100252330 | 05 | IN | MEDICAID |