Provider Demographics
NPI:1396754016
Name:TURNER, MARTY WAYNE (MD)
Entity type:Individual
Prefix:
First Name:MARTY
Middle Name:WAYNE
Last Name:TURNER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:323 N ROSE HILL RD
Mailing Address - Street 2:
Mailing Address - City:ROSE HILL
Mailing Address - State:KS
Mailing Address - Zip Code:67133-9428
Mailing Address - Country:US
Mailing Address - Phone:316-776-2422
Mailing Address - Fax:316-776-2879
Practice Address - Street 1:323 N ROSE HILL RD
Practice Address - Street 2:
Practice Address - City:ROSE HILL
Practice Address - State:KS
Practice Address - Zip Code:67133-9428
Practice Address - Country:US
Practice Address - Phone:316-776-2422
Practice Address - Fax:316-776-2879
Is Sole Proprietor?:No
Enumeration Date:2006-08-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS04-27793207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS104382OtherBC/BS
KSP00205805OtherMEDICARE RAILROAD
KSG81771Medicare UPIN
KS104382Medicare ID - Type Unspecified