Provider Demographics
NPI:1386643104
Name:TURGEON, PAUL W (MD)
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:W
Last Name:TURGEON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:730 MCKINLEY AVE NW
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44703-3404
Mailing Address - Country:US
Mailing Address - Phone:330-458-3000
Mailing Address - Fax:330-458-3006
Practice Address - Street 1:800 MCKINLEY AVE NW
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44703-2463
Practice Address - Country:US
Practice Address - Phone:330-452-8884
Practice Address - Fax:330-452-2404
Is Sole Proprietor?:No
Enumeration Date:2005-07-14
Last Update Date:2008-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-058263207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0737831Medicaid
E02501Medicare UPIN
TU0632313Medicare ID - Type Unspecified