Provider Demographics
NPI:1588077473
Name:TURNER, DAVID
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:TURNER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4455 HIGHWAY 169 N
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH
Mailing Address - State:MN
Mailing Address - Zip Code:55442-2897
Mailing Address - Country:US
Mailing Address - Phone:763-559-7358
Mailing Address - Fax:763-559-2167
Practice Address - Street 1:94 14TH ST NE
Practice Address - Street 2:SUITE 3
Practice Address - City:BUFFALO
Practice Address - State:MN
Practice Address - Zip Code:55313-1932
Practice Address - Country:US
Practice Address - Phone:763-746-3391
Practice Address - Fax:763-682-5899
Is Sole Proprietor?:No
Enumeration Date:2014-06-09
Last Update Date:2014-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN3390152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist