Healthcare Provider Details

I. General information

NPI: 1801271754
Provider Name (Legal Business Name): CLIFTON DALE TURNER D.P.M.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/21/2015
Last Update Date: 07/21/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3461 WARRENSVILLE CENTER RD SUITE 201
SHAKER HEIGHTS OH
44122-5260
US

IV. Provider business mailing address

PO BOX 202171
CLEVELAND OH
44120-8119
US

V. Phone/Fax

Practice location:
  • Phone: 216-210-9946
  • Fax:
Mailing address:
  • Phone: 216-210-9946
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0131X
TaxonomyFoot Surgery Podiatrist
License Number36002359
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: