Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207QA0401X | Family Doctor - Addiction Medicine | 01047367A | IN |
Y | 207QA0505X | Family Doctor - Adult Medicine | 01047367A | IN |
NPI | 1144372863 |
---|---|
Provider Name | Dr. Robert Charles Turner |
First Address | Lafayette, IN 47909-8417 |
Second Address | Lafayette, IN 47909-8417 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/01/2007 |
Last Update Date | 01/09/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000000186822 | ANTHEM BLUE CROSS (01) | IN |
F13205 | (02) |