Basic Information
| Provider Information | |||||||||
| NPI: | 1407834906 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | TURNER | ||||||||
| FirstName: | MICHAEL | ||||||||
| MiddleName: | A | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 520 VALLEY VIEW DR | ||||||||
| Address2: | |||||||||
| City: | MOLINE | ||||||||
| State: | IL | ||||||||
| PostalCode: | 612656194 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3097623621 | ||||||||
| FaxNumber: | 3097623690 | ||||||||
| Practice Location | |||||||||
| Address1: | 520 VALLEY VIEW DR | ||||||||
| Address2: | |||||||||
| City: | MOLINE | ||||||||
| State: | IL | ||||||||
| PostalCode: | 612656194 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3097623621 | ||||||||
| FaxNumber: | 3097623690 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/04/2006 | ||||||||
| LastUpdateDate: | 03/18/2011 | ||||||||
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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 | 207X00000X | 036083168 | IL | Y | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | 207X00000X | 28388 | IA | N | Allopathic & Osteopathic Physicians | Orthopaedic Surgery |
ID Information
| ID | Type | State | Issuer | Description | 036083168 | 05 | IL | MEDICAID | 92929 | 01 | WELLMARK | OTHER | 05343 | 01 | WELLMARK | OTHER | 020375 | 01 | HEALTH ALLIANCE | OTHER | 20020 | 01 | IA HEALTH SOLUTIONS | OTHER | 91389 | 01 | WELLMARK | OTHER | T16114 | 01 | IL | JOHN DEERE FAMILY | OTHER | 200011706 | 01 | RR MEDICARE | OTHER | 8121085 | 01 | IL | BCBS | OTHER | 0910679 | 05 | IA | MEDICAID | IA0192 | 01 | IA | JOHN DEERE FAMILY | OTHER | 17648 | 01 | MIDLANDS CHOICE | OTHER |