Healthcare Provider Details

I. General information

NPI: 1720075625
Provider Name (Legal Business Name): DENNIS TURNER JR. M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/05/2005
Last Update Date: 09/04/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

550 PEACHTREE ST NE SUTIE 1420
ATLANTA GA
30308-2208
US

IV. Provider business mailing address

550 PEACHTREE ST NE SUTIE 1420
ATLANTA GA
30308-2208
US

V. Phone/Fax

Practice location:
  • Phone: 404-658-0008
  • Fax: 404-526-9053
Mailing address:
  • Phone: 404-658-0008
  • Fax: 404-526-9053

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number015520
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: