Healthcare Provider Details

I. General information

NPI: 1316017304
Provider Name (Legal Business Name): CARL ROBERT TURNER M.D., F.A.A.P.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/08/2006
Last Update Date: 02/09/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

304 UNIVERSITY AVE SUITE 105
MARSHALL TX
75670-5210
US

IV. Provider business mailing address

304 UNIVERSITY SUITE 105
MARSHALL TX
75670
US

V. Phone/Fax

Practice location:
  • Phone: 903-935-9441
  • Fax: 903-938-1246
Mailing address:
  • Phone: 903-935-9441
  • Fax: 903-938-1246

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberE4728
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: