Provider Demographics
NPI:1104230986
Name:TURNER, DERRICK JULIAN (MSW)
Entity type:Individual
Prefix:MR
First Name:DERRICK
Middle Name:JULIAN
Last Name:TURNER
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:738 S FRED SHUTTLESWORTH CIR
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45229-2113
Mailing Address - Country:US
Mailing Address - Phone:216-374-9514
Mailing Address - Fax:
Practice Address - Street 1:738 S FRED SHUTTLESWORTH CIR
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45229-2113
Practice Address - Country:US
Practice Address - Phone:216-374-9514
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-19
Last Update Date:2022-10-24
Deactivation Date:2022-10-13
Deactivation Code:
Reactivation Date:2022-10-24
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker