Provider Demographics
NPI:1629107057
Name:TURK, WILLIAM A (OD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:A
Last Name:TURK
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
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:406-538-7703
Mailing Address - Fax:406-538-7705
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:406-538-7703
Practice Address - Fax:406-538-7705
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-02
Last Update Date:2009-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT359152WC0802X, 152WP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management
No152WP0200XEye and Vision Services ProvidersOptometristPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT81-0380094OtherEMPLOYER NUMBER
MT481351Medicaid
MT81-0380094OtherEMPLOYER NUMBER
MT000002509Medicare ID - Type Unspecified
MT481351Medicaid