MEDICARE: BRIDGET KOCH TURNER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist

General Provider Information

NPI Number	:	1235393034
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRIDGET KOCH TURNER

Provider Business Mailing Address
First Line	:	7281 LAWN TENNIS LN
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32277-9363
Country	:	US
Telephone Number	:	904-744-6834
Fax Number	:

Provider Business Practice Location Address
First Line	:	7281 LAWN TENNIS LN
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32277-9363
Country	:	US
Telephone Number	:	904-744-6834
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/11/2008
Last Update Date	:	07/11/2008

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Directions to “ BRIDGET KOCH TURNER ” Practice Location

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