MEDICARE: MR. DONALD JASON TURNER PA-C

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	363A00000X	Physician Assistant	1050185
2	363A00000X	Physician Assistant	1763	SC

General Provider Information

NPI Number	:	1245219211
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. DONALD JASON TURNER PA-C

Provider Business Mailing Address
First Line	:	PO BOX 1245
Second Line	:
City	:	ORANGEBURG
State	:	SC
Zip	:	29116-1245
Country	:	US
Telephone Number	:	803-395-4497
Fax Number	:	803-536-0998

Provider Business Practice Location Address
First Line	:	111 JOHN LAWSON AVE
Second Line	:
City	:	SANTEE
State	:	SC
Zip	:	29142-8654
Country	:	US
Telephone Number	:	803-395-2090
Fax Number	:

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

Provider Enumeration Date	:	01/10/2006
Last Update Date	:	04/23/2013

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