Provider Demographics
NPI:1134124704
Name:TURTLE, DAVID THOMAS (OD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:THOMAS
Last Name:TURTLE
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:444 PAYNE AVE
Mailing Address - Street 2:
Mailing Address - City:NORTH TONAWANDA
Mailing Address - State:NY
Mailing Address - Zip Code:14120-6902
Mailing Address - Country:US
Mailing Address - Phone:716-693-1280
Mailing Address - Fax:716-693-1383
Practice Address - Street 1:444 PAYNE AVE
Practice Address - Street 2:
Practice Address - City:NORTH TONAWANDA
Practice Address - State:NY
Practice Address - Zip Code:14120-6902
Practice Address - Country:US
Practice Address - Phone:716-693-1280
Practice Address - Fax:716-693-1383
Is Sole Proprietor?:No
Enumeration Date:2005-06-20
Last Update Date:2007-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYVUT005265152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
000300010007OtherBCBS
000300010003OtherBCBS
NY0597890003OtherMEDICARE DME
000300010001OtherBCBS
NY0597890001OtherMEDICARE DME
NY5265OtherEYEMED
7209479OtherINDEPENDENT HEALTH
7309539OtherINDEPENDENT HEALTH
00025972201OtherUNIVERA
NY0597890002OtherMEDICARE DME
NY0597890004OtherMEDICARE DME
000300010005OtherBCBS
7209479OtherINDEPENDENT HEALTH
000300010001OtherBCBS
000300010007OtherBCBS