Provider Demographics
NPI:1215927421
Name:TURNER, MICHAEL CLARK (DO)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:CLARK
Last Name:TURNER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1600 FOREST AVE
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36106-1542
Mailing Address - Country:US
Mailing Address - Phone:334-261-4445
Mailing Address - Fax:334-261-4448
Practice Address - Street 1:1600 FOREST AVE
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36106-1542
Practice Address - Country:US
Practice Address - Phone:334-261-4445
Practice Address - Fax:334-261-4448
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-27
Last Update Date:2010-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALDO643207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL943430149OtherHMO PROVIDER NUMBER
AL943430149OtherHMO PROVIDER NUMBER
ALH07438Medicare UPIN