Basic Information
| Provider Information | |||||||||
| NPI: | 1811962541 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | TURNER | ||||||||
| FirstName: | JAY | ||||||||
| MiddleName: | D | ||||||||
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| Credential: | AUD., CCC-A | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3303 N UNIVERSITY AVE | ||||||||
| Address2: | |||||||||
| City: | PROVO | ||||||||
| State: | UT | ||||||||
| PostalCode: | 846044438 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8013737438 | ||||||||
| FaxNumber: | 8013737486 | ||||||||
| Practice Location | |||||||||
| Address1: | 3303 N UNIVERSITY AVE | ||||||||
| Address2: | |||||||||
| City: | PROVO | ||||||||
| State: | UT | ||||||||
| PostalCode: | 846044438 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8013737438 | ||||||||
| FaxNumber: | 8013737486 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/17/2006 | ||||||||
| LastUpdateDate: | 02/28/2017 | ||||||||
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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 | 231H00000X | 9818436-4101 | UT | Y | Speech, Language and Hearing Service Providers | Audiologist |
ID Information
| ID | Type | State | Issuer | Description | 1447275946 | 05 | UT | MEDICAID |