Provider Demographics
NPI:1578327151
Name:TURNER, DEBORA ELAINE
Entity Type:Individual
Prefix:MS
First Name:DEBORA
Middle Name:ELAINE
Last Name:TURNER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7012 W FAYETTEVILLE RD
Mailing Address - Street 2:
Mailing Address - City:RIVERDALE
Mailing Address - State:GA
Mailing Address - Zip Code:30296-1908
Mailing Address - Country:US
Mailing Address - Phone:404-781-7175
Mailing Address - Fax:770-994-0128
Practice Address - Street 1:6149 OLD NATIONAL HWY
Practice Address - Street 2:
Practice Address - City:COLLEGE PARK
Practice Address - State:GA
Practice Address - Zip Code:30349-4479
Practice Address - Country:US
Practice Address - Phone:770-994-0141
Practice Address - Fax:770-994-0128
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-13
Last Update Date:2024-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA002576156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOpticianGroup - Single Specialty