Provider Demographics
NPI:1104013614
Name:TURNER, BRANT WALTON (PA-C)
Entity type:Individual
Prefix:
First Name:BRANT
Middle Name:WALTON
Last Name:TURNER
Suffix:
Gender:
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:420 THE PKWY STE N
Mailing Address - Street 2:
Mailing Address - City:GREER
Mailing Address - State:SC
Mailing Address - Zip Code:29650-5205
Mailing Address - Country:US
Mailing Address - Phone:864-743-1776
Mailing Address - Fax:864-214-4749
Practice Address - Street 1:115 BRUSHY CREEK RD
Practice Address - Street 2:
Practice Address - City:EASLEY
Practice Address - State:SC
Practice Address - Zip Code:29642-1120
Practice Address - Country:US
Practice Address - Phone:864-635-0376
Practice Address - Fax:864-442-6848
Is Sole Proprietor?:No
Enumeration Date:2007-09-28
Last Update Date:2025-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC1249363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC0948PAMedicaid
SCSC67806672OtherMEDICARE PTAN
SC0948PAMedicaid
SCSC67806672OtherMEDICARE PTAN