Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213EP1101X | Primary Podiatric Medicine | PO 850 | FL |
NPI | 1295864874 |
---|---|
Provider Name | Dr. Turner Orlan Houston JR. |
First Address | Atlantic Beach, FL 32233-3841 |
Second Address | Atlantic Beach, FL 32233-3841 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/03/2007 |
Last Update Date | 16/06/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
T95145 | (02) |