Healthcare Provider Details

I. General information

NPI: 1548097546
Provider Name (Legal Business Name): MELVIN TURNER III H.I.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/16/2024
Last Update Date: 07/09/2026
Certification Date: 07/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1510 48TH STREET PL
MOLINE IL
61265-3637
US

IV. Provider business mailing address

1754 VALLEY DR
DAVENPORT IA
52806-2551
US

V. Phone/Fax

Practice location:
  • Phone: 309-981-8124
  • Fax:
Mailing address:
  • Phone: 309-981-8124
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License Number2024035077
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: