MEDICARE: DR. CHARLES JASON TURNER O.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	1363	SC

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	AA11198351	OTHER	SC	MEDICARE PROVIDER NUMBER

General Provider Information

NPI Number	:	1689643918
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHARLES JASON TURNER O.D.

Provider Business Mailing Address
First Line	:	250 SEVEN FARMS DR
Second Line	:	SUITE A
City	:	DANIEL ISLAND
State	:	SC
Zip	:	29492-8159
Country	:	US
Telephone Number	:	843-471-2733
Fax Number	:	843-471-2735

Provider Business Practice Location Address
First Line	:	250 SEVEN FARMS DR
Second Line	:	SUITE A
City	:	DANIEL ISLAND
State	:	SC
Zip	:	29492-8159
Country	:	US
Telephone Number	:	843-471-2733
Fax Number	:	843-471-2735

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/17/2006
Last Update Date	:	12/21/2012

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