Provider Demographics
NPI:1710029582
Name:MCTURK, PAUL (DO)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:
Last Name:MCTURK
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3817 SCARBOROUGH CT
Mailing Address - Street 2:
Mailing Address - City:CLERMONT
Mailing Address - State:FL
Mailing Address - Zip Code:34711-6982
Mailing Address - Country:US
Mailing Address - Phone:630-280-9701
Mailing Address - Fax:352-536-8141
Practice Address - Street 1:3817 SCARBOROUGH CT
Practice Address - Street 2:
Practice Address - City:CLERMONT
Practice Address - State:FL
Practice Address - Zip Code:34711-6982
Practice Address - Country:US
Practice Address - Phone:630-280-9701
Practice Address - Fax:352-536-8141
Is Sole Proprietor?:No
Enumeration Date:2007-02-12
Last Update Date:2020-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036113686207Q00000X
IN02002897A207Q00000X
FLOS11956207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLOS11956OtherMEDICAL LICENSE
FLOS11956OtherMEDICAL LICENSE