Provider Demographics
NPI:1740337518
Name:TURKE, TERRY L (MD)
Entity type:Individual
Prefix:DR
First Name:TERRY
Middle Name:L
Last Name:TURKE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:132 HOSPITAL DR
Mailing Address - Street 2:
Mailing Address - City:WATERTOWN
Mailing Address - State:WI
Mailing Address - Zip Code:53098-3304
Mailing Address - Country:US
Mailing Address - Phone:920-261-2020
Mailing Address - Fax:920-261-0457
Practice Address - Street 1:132 HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:WATERTOWN
Practice Address - State:WI
Practice Address - Zip Code:53098-3304
Practice Address - Country:US
Practice Address - Phone:920-261-2020
Practice Address - Fax:920-261-0457
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-04
Last Update Date:2016-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI18818207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI31092400Medicaid
WI31092400Medicaid
WI31092400Medicaid