Basic Information
Provider Information
NPI: 1295227619
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: TURNER
FirstName: RODRICK
MiddleName: MAURICE
NamePrefix:  
NameSuffix:  
Credential: CRNA
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1 SEAGATE STE 800
Address2:  
City: TOLEDO
State: OH
PostalCode: 436041558
CountryCode: US
TelephoneNumber: 5675851997
FaxNumber:  
Practice Location
Address1: 1200 RALSTON AVE
Address2:  
City: DEFIANCE
State: OH
PostalCode: 435121396
CountryCode: US
TelephoneNumber: 4197836944
FaxNumber: 4197834416
Other Information
ProviderEnumerationDate: 06/01/2018
LastUpdateDate: 06/01/2018
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
367500000XAPRN.CRNA.019692OHY Physician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered 

No ID Information.


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