Basic Information
| Provider Information | |||||||||
| NPI: | 1386685501 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | TURNER | ||||||||
| FirstName: | JOHN | ||||||||
| MiddleName: | CHARLES | ||||||||
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| Credential: | MD PHD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1900 N WINSTON RD | ||||||||
| Address2: | SUITE 300 | ||||||||
| City: | KNOXVILLE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 379193606 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8656931000 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1901 W CLINCH AVE | ||||||||
| Address2: | |||||||||
| City: | KNOXVILLE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 379162307 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8655411111 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/09/2006 | ||||||||
| LastUpdateDate: | 09/13/2007 | ||||||||
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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 | 207P00000X | MD12676 | TN | Y | Allopathic & Osteopathic Physicians | Emergency Medicine |
ID Information
| ID | Type | State | Issuer | Description | 0123683 | 01 | TN | BLUE CROSS | OTHER | 3069930 | 01 | TN | BLUE CROSS | OTHER | 3087582 | 01 | TN | BLUE CROSS | OTHER | 3809998 | 05 | TN | MEDICAID | 3809995 | 05 | TN | MEDICAID |