Provider Demographics
NPI:1528202330
Name:DR WILLIAM A TURK PC
Entity Type:Organization
Organization Name:DR WILLIAM A TURK PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DR
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:A
Authorized Official - Last Name:TURK
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:406-538-7703
Mailing Address - Street 1:611 NE MAIN ST
Mailing Address - Street 2:
Mailing Address - City:LEWISTOWN
Mailing Address - State:MT
Mailing Address - Zip Code:59457-2020
Mailing Address - Country:US
Mailing Address - Phone:406-598-7703
Mailing Address - Fax:409-538-7705
Practice Address - Street 1:611 NE MAIN ST
Practice Address - Street 2:
Practice Address - City:LEWISTOWN
Practice Address - State:MT
Practice Address - Zip Code:59457-2020
Practice Address - Country:US
Practice Address - Phone:406-598-7703
Practice Address - Fax:409-538-7705
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-23
Last Update Date:2009-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTMT359305R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305R00000XManaged Care OrganizationsPreferred Provider Organization
Provider Identifiers
StateIdentifier IDID TypeIssuer
0643980001Medicare NSC
MT1528202330Medicare NSC