Provider Demographics
NPI:1154358364
Name:RUMBLE, MICHAEL TURNER (MD)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:TURNER
Last Name:RUMBLE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 102321
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30368-2321
Mailing Address - Country:US
Mailing Address - Phone:770-801-2526
Mailing Address - Fax:770-803-2121
Practice Address - Street 1:80 INTERSTATE SOUTH DR
Practice Address - Street 2:SUITE B
Practice Address - City:JASPER
Practice Address - State:GA
Practice Address - Zip Code:30143-6226
Practice Address - Country:US
Practice Address - Phone:678-454-3306
Practice Address - Fax:678-454-3311
Is Sole Proprietor?:No
Enumeration Date:2006-06-26
Last Update Date:2015-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA031657208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
F23647Medicare UPIN
3066545Medicare ID - Type Unspecified
TN3066545Medicaid
TN0137423OtherBCBST