Provider Demographics
NPI:1477720043
Name:THOMAS C TURKIN, DPM, PC
Entity type:Organization
Organization Name:THOMAS C TURKIN, DPM, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:
Authorized Official - Last Name:TURKIN
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:810-227-3864
Mailing Address - Street 1:7990 W. GRAND RIVER AVE
Mailing Address - Street 2:STE D
Mailing Address - City:BRIGHTON
Mailing Address - State:MI
Mailing Address - Zip Code:48114-7326
Mailing Address - Country:US
Mailing Address - Phone:810-227-3864
Mailing Address - Fax:810-227-3865
Practice Address - Street 1:7990 W. GRAND RIVER AVE
Practice Address - Street 2:STE D
Practice Address - City:BRIGHTON
Practice Address - State:MI
Practice Address - Zip Code:48114-7326
Practice Address - Country:US
Practice Address - Phone:810-227-3864
Practice Address - Fax:810-227-3865
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-13
Last Update Date:2010-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MITT000827213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4854756090OtherBLUE CROSS BLUE SHIELD
MI132093528Medicaid
MI5918960001Medicare NSC
MI4854756090OtherBLUE CROSS BLUE SHIELD
MI132093528Medicaid