Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208800000X | Urologist | R1975 | AR |
NPI | 1013990746 |
---|---|
Provider Name | Jan Thomas Turley |
First Address | Rogers, AR 72756 |
Second Address | Rogers, AR 72756 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/11/2005 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
B90637 | (02) |