Provider Demographics
NPI:1235594391
Name:TRUSIGHT OPTOMETRY, LLC
Entity Type:Organization
Organization Name:TRUSIGHT OPTOMETRY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:NOLAN
Authorized Official - Middle Name:
Authorized Official - Last Name:TURK
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:480-828-3480
Mailing Address - Street 1:2662 E VERMONT CT
Mailing Address - Street 2:
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85295-2321
Mailing Address - Country:US
Mailing Address - Phone:541-729-0708
Mailing Address - Fax:
Practice Address - Street 1:6525 E SOUTHERN AVE
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85206-3711
Practice Address - Country:US
Practice Address - Phone:480-985-5405
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-16
Last Update Date:2015-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ1982152W00000X
AZ1981152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty