Provider Demographics
NPI:1558637512
Name:ALTHEA L. TURK,M.D.,P.C.
Entity Type:Organization
Organization Name:ALTHEA L. TURK,M.D.,P.C.
Other - Org Name:COMPREHENSIVE EYE CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO(OWNER)
Authorized Official - Prefix:
Authorized Official - First Name:ALTHEA
Authorized Official - Middle Name:LORRAINE
Authorized Official - Last Name:TURK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:404-221-0681
Mailing Address - Street 1:PO BOX 92759
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30314-0759
Mailing Address - Country:US
Mailing Address - Phone:404-221-0681
Mailing Address - Fax:404-681-0900
Practice Address - Street 1:315 BOULEVARD NE
Practice Address - Street 2:SUITE 242
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30312-1200
Practice Address - Country:US
Practice Address - Phone:404-221-0681
Practice Address - Fax:404-681-0900
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-23
Last Update Date:2012-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000226982AMedicaid
GA000226982AMedicaid