Healthcare Provider Details

I. General information

NPI: 1760616411
Provider Name (Legal Business Name): KEVIN NEIL TURNER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/11/2009
Last Update Date: 03/29/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2001 KINGSLEY AVE FL 2
ORANGE PARK FL
32073-5148
US

IV. Provider business mailing address

2001 KINGSLEY AVE FL 2
ORANGE PARK FL
32073-5148
US

V. Phone/Fax

Practice location:
  • Phone: 904-639-2667
  • Fax:
Mailing address:
  • Phone: 904-639-2667
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA107588
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code2080N0001X
TaxonomyNeonatal-Perinatal Medicine Physician
License NumberME118770
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: