Provider Demographics
NPI:1548254451
Name:TURNER, MARY KAY (MD)
Entity type:Individual
Prefix:DR
First Name:MARY
Middle Name:KAY
Last Name:TURNER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1801 N SENATE BLVD
Mailing Address - Street 2:STE 740
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46202-1228
Mailing Address - Country:US
Mailing Address - Phone:317-962-6262
Mailing Address - Fax:317-962-5783
Practice Address - Street 1:1801 N SENATE BLVD
Practice Address - Street 2:STE 740
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46202-1228
Practice Address - Country:US
Practice Address - Phone:317-962-6262
Practice Address - Fax:317-962-5783
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-07
Last Update Date:2011-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01036834208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000000307625OtherBCBS
IN100101770BMedicaid
IN523410Medicare ID - Type Unspecified
IN000000307625OtherBCBS