Healthcare Provider Details

I. General information

NPI: 1144372863
Provider Name (Legal Business Name): ROBERT CHARLES TURNER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/16/2007
Last Update Date: 04/18/2024
Certification Date: 04/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3554 PROMENADE PKWY SUITE H
LAFAYETTE IN
47909-8417
US

IV. Provider business mailing address

3554 PROMENADE PKWY SUITE H
LAFAYETTE IN
47909-8417
US

V. Phone/Fax

Practice location:
  • Phone: 765-471-1100
  • Fax: 765-471-1009
Mailing address:
  • Phone: 765-471-1100
  • Fax: 765-471-1009

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207QB0002X
TaxonomyObesity Medicine (Family Medicine) Physician
License Number01047367A
License Number StateIN
# 2
Primary TaxonomyY
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License Number01047367A
License Number StateIN
# 3
Primary TaxonomyN
Taxonomy Code207QA0401X
TaxonomyAddiction Medicine (Family Medicine) Physician
License Number01047367A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: