Provider Demographics
NPI:1427094614
Name:TURNER, GLEN A (MD)
Entity type:Individual
Prefix:DR
First Name:GLEN
Middle Name:A
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:PO BOX 635283
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45263-5283
Mailing Address - Country:US
Mailing Address - Phone:859-757-2927
Mailing Address - Fax:859-341-0203
Practice Address - Street 1:651 CENTRE VIEW BLVD
Practice Address - Street 2:
Practice Address - City:CRESTVIEW HILLS
Practice Address - State:KY
Practice Address - Zip Code:41017-5423
Practice Address - Country:US
Practice Address - Phone:859-757-2927
Practice Address - Fax:859-341-0203
Is Sole Proprietor?:No
Enumeration Date:2006-06-22
Last Update Date:2018-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY37479174400000X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
021036000OtherFEDERAL BLACK LUNG
3048114OtherAETNA
KY64938368Medicaid
50005341OtherPASSPORT
OH0979035Medicaid
310674100OtherUS DEPT OF LABOR
000000296901OtherANTHEM
4820116OtherUNITED HEALTHCARE
IN201127140Medicaid
KYP00935621OtherRAILROAD MEDICARE
021036000OtherFEDERAL BLACK LUNG
KY64938368Medicaid
KY0399017Medicare PIN
4820116OtherUNITED HEALTHCARE
3048114OtherAETNA
KYP00935621OtherRAILROAD MEDICARE
50005341OtherPASSPORT
KYP00028400Medicare PIN
KY0969422Medicare PIN