Provider Demographics
NPI:1073246351
Name:TURNER, ROBERT DENNIS JR
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:DENNIS
Last Name:TURNER
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:WALMART 0629
Mailing Address - Street 2:513 N DUNCAN BYPASS
Mailing Address - City:UNION
Mailing Address - State:SC
Mailing Address - Zip Code:29379
Mailing Address - Country:US
Mailing Address - Phone:864-762-5006
Mailing Address - Fax:864-427-1020
Practice Address - Street 1:WALMART 0629
Practice Address - Street 2:513 N DUNCAN BYPASS
Practice Address - City:UNION
Practice Address - State:SC
Practice Address - Zip Code:29379
Practice Address - Country:US
Practice Address - Phone:864-762-5006
Practice Address - Fax:864-427-1020
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-05
Last Update Date:2022-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC471156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician