Provider Demographics
NPI:1336707124
Name:TURTON, JAKE MATTHEW (NP)
Entity Type:Individual
Prefix:MR
First Name:JAKE
Middle Name:MATTHEW
Last Name:TURTON
Suffix:
Gender:M
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3320 OLD JEFFERSON RD
Mailing Address - Street 2:STE 200A
Mailing Address - City:ATHENS
Mailing Address - State:GA
Mailing Address - Zip Code:30607-1478
Mailing Address - Country:US
Mailing Address - Phone:706-549-5560
Mailing Address - Fax:706-353-0636
Practice Address - Street 1:3320 OLD JEFFERSON RD STE 200A
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:GA
Practice Address - Zip Code:30607-1478
Practice Address - Country:US
Practice Address - Phone:706-549-5560
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-05
Last Update Date:2019-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN230145363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care