Healthcare Provider Details

I. General information

NPI: 1720212418
Provider Name (Legal Business Name): TURNER OPTOMETRIC SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/08/2009
Last Update Date: 05/08/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

94 CECIL ST
CAMDENTON MO
65020-7057
US

IV. Provider business mailing address

143 WOODFIELD DR
HIGHLANDVILLE MO
65669-8375
US

V. Phone/Fax

Practice location:
  • Phone: 573-317-9279
  • Fax: 573-317-1248
Mailing address:
  • Phone: 417-569-3473
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number2004019339
License Number StateMO

VIII. Authorized Official

Name: DR. MICHAEL EUGENE TURNER
Title or Position: PRESIDENT/OPTOMETRIST
Credential: O.D.
Phone: 417-569-3473