Provider Demographics
NPI:1588752455
Name:TURLEY, JOHN WALTER (OD)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:WALTER
Last Name:TURLEY
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:218 W 75TH ST
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64114-5737
Mailing Address - Country:US
Mailing Address - Phone:816-444-1810
Mailing Address - Fax:816-444-7709
Practice Address - Street 1:218 W 75TH ST
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64114-5737
Practice Address - Country:US
Practice Address - Phone:816-444-1810
Practice Address - Fax:816-444-7709
Is Sole Proprietor?:No
Enumeration Date:2006-10-10
Last Update Date:2008-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOTO2352152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO0000813AMedicare PIN
MO4076080001Medicare NSC
MOT42535Medicare UPIN