Provider Demographics
NPI:1629034582
Name:TURNBULL, J. GREGORY (PSYD)
Entity Type:Individual
Prefix:DR
First Name:J.
Middle Name:GREGORY
Last Name:TURNBULL
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:DR
Other - First Name:JAMES
Other - Middle Name:GREGORY
Other - Last Name:TURNBULL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PSYD
Mailing Address - Street 1:603 PAOPUA LOOP
Mailing Address - Street 2:
Mailing Address - City:KAILUA
Mailing Address - State:HI
Mailing Address - Zip Code:96734-3535
Mailing Address - Country:US
Mailing Address - Phone:808-398-8666
Mailing Address - Fax:888-527-8662
Practice Address - Street 1:603 PAOPUA LOOP
Practice Address - Street 2:
Practice Address - City:KAILUA
Practice Address - State:HI
Practice Address - Zip Code:96734-3535
Practice Address - Country:US
Practice Address - Phone:808-398-8666
Practice Address - Fax:888-527-8662
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-20
Last Update Date:2014-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIPSY 929103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI58194301Medicaid
HI0000258160OtherBCBS HAWAII HAWAII MEDICAL SERVICES ASSOCIATION (HMSA)