Provider Demographics
NPI:1699927848
Name:GREGORY WINFIELD TURNER SR MD PA
Entity type:Organization
Organization Name:GREGORY WINFIELD TURNER SR MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:WINFIELD
Authorized Official - Last Name:TURNER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:850-897-2000
Mailing Address - Street 1:4400 E HIGHWAY 20
Mailing Address - Street 2:SUITE 410
Mailing Address - City:NICEVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32578-8779
Mailing Address - Country:US
Mailing Address - Phone:850-897-2000
Mailing Address - Fax:850-897-4359
Practice Address - Street 1:4400 E HIGHWAY 20
Practice Address - Street 2:SUITE 410
Practice Address - City:NICEVILLE
Practice Address - State:FL
Practice Address - Zip Code:32578-8779
Practice Address - Country:US
Practice Address - Phone:850-897-2000
Practice Address - Fax:850-897-4359
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-21
Last Update Date:2008-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0039657207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLD54964Medicare UPIN