Basic Information
| Provider Information | |||||||||
| NPI: | 1609957042 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | TURPEN | ||||||||
| FirstName: | RYAN | ||||||||
| MiddleName: | MICHAEL | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 230 W MAIN ST | ||||||||
| Address2: | SUITE 102 | ||||||||
| City: | DANVILLE | ||||||||
| State: | KY | ||||||||
| PostalCode: | 404221871 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8592392700 | ||||||||
| FaxNumber: | 8592367656 | ||||||||
| Practice Location | |||||||||
| Address1: | 230 W MAIN ST | ||||||||
| Address2: | SUITE 102 | ||||||||
| City: | DANVILLE | ||||||||
| State: | KY | ||||||||
| PostalCode: | 404221871 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8592392700 | ||||||||
| FaxNumber: | 8592367656 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/18/2006 | ||||||||
| LastUpdateDate: | 05/03/2017 | ||||||||
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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 | 208800000X | TRN10124 | FL | N | Allopathic & Osteopathic Physicians | Urology | 208800000X | 44738 | KY | Y | Allopathic & Osteopathic Physicians | Urology |
ID Information
| ID | Type | State | Issuer | Description | 7100196440 | 05 | KY | MEDICAID |