Healthcare Provider Details

I. General information

NPI: 1851377022
Provider Name (Legal Business Name): HARRY SPENCER TURNER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/20/2005
Last Update Date: 10/17/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

463142 STATE ROAD 200
YULEE FL
32097-5554
US

IV. Provider business mailing address

503 STARBOARD LNDG
FERNANDINA BEACH FL
32034-2779
US

V. Phone/Fax

Practice location:
  • Phone: 904-225-8280
  • Fax:
Mailing address:
  • Phone: 904-321-0506
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2083P0901X
TaxonomyPublic Health & General Preventive Medicine Physician
License Number86591
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: