Provider Demographics
NPI:1811901895
Name:TURNQUIST, JACOB LAWRENCE (MD)
Entity type:Individual
Prefix:
First Name:JACOB
Middle Name:LAWRENCE
Last Name:TURNQUIST
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 603725
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28260-3725
Mailing Address - Country:US
Mailing Address - Phone:828-575-2625
Mailing Address - Fax:828-350-2174
Practice Address - Street 1:5085 MORGANTON RD STE 100
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28314-1497
Practice Address - Country:US
Practice Address - Phone:910-323-3890
Practice Address - Fax:910-323-4509
Is Sole Proprietor?:No
Enumeration Date:2006-07-28
Last Update Date:2023-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2022-03226207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1811901895Medicaid
NCNNS192BOtherMEDICARE PTAN