Provider Demographics
NPI:1316044209
Name:TURNER, GLEN CLAUDE (O D)
Entity Type:Individual
Prefix:DR
First Name:GLEN
Middle Name:CLAUDE
Last Name:TURNER
Suffix:
Gender:M
Credentials:O D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1405 N 400 W
Mailing Address - Street 2:
Mailing Address - City:CENTERVILLE
Mailing Address - State:UT
Mailing Address - Zip Code:84014-1127
Mailing Address - Country:US
Mailing Address - Phone:801-809-8040
Mailing Address - Fax:801-546-1240
Practice Address - Street 1:745 W HILL FIELD RD
Practice Address - Street 2:
Practice Address - City:LAYTON
Practice Address - State:UT
Practice Address - Zip Code:84041-4602
Practice Address - Country:US
Practice Address - Phone:801-546-4759
Practice Address - Fax:801-546-1240
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT1139899934152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist