Provider Demographics
NPI:1902809130
Name:TURNER, MARTHA M (MD)
Entity Type:Individual
Prefix:DR
First Name:MARTHA
Middle Name:M
Last Name:TURNER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:CANDY
Other - Middle Name:
Other - Last Name:TURNER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:1005 COLLEGE VIEW DR
Mailing Address - Street 2:
Mailing Address - City:RIVERTON
Mailing Address - State:WY
Mailing Address - Zip Code:82501-2289
Mailing Address - Country:US
Mailing Address - Phone:307-857-3488
Mailing Address - Fax:
Practice Address - Street 1:1005 COLLEGE VIEW DR
Practice Address - Street 2:
Practice Address - City:RIVERTON
Practice Address - State:WY
Practice Address - Zip Code:82501-2289
Practice Address - Country:US
Practice Address - Phone:307-857-3488
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-05-23
Last Update Date:2015-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA020692208D00000X
WY9600A208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
LAE46105Medicare UPIN