Provider Demographics
NPI:1750939179
Name:TUROK, PAUL THOMAS (CERTIFIED OCCUPATION)
Entity type:Individual
Prefix:
First Name:PAUL
Middle Name:THOMAS
Last Name:TUROK
Suffix:
Gender:M
Credentials:CERTIFIED OCCUPATION
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 BROOKBERRY RD
Mailing Address - Street 2:
Mailing Address - City:MOUNT AIRY
Mailing Address - State:NC
Mailing Address - Zip Code:27030-2413
Mailing Address - Country:US
Mailing Address - Phone:208-570-5532
Mailing Address - Fax:
Practice Address - Street 1:1000 RIDGE CREST LN
Practice Address - Street 2:
Practice Address - City:MOUNT AIRY
Practice Address - State:NC
Practice Address - Zip Code:27030-2457
Practice Address - Country:US
Practice Address - Phone:336-786-9100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-28
Last Update Date:2019-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC12414208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation