Healthcare Provider Details

I. General information

NPI: 1235825985
Provider Name (Legal Business Name): KEVIN CHRISTOPHER TURNER OD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/14/2023
Last Update Date: 11/12/2024
Certification Date: 11/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

510 BUTLER AVE
MARTINSBURG WV
25405-9991
US

IV. Provider business mailing address

146 SETTLERS LN
CAPON BRIDGE WV
26711
US

V. Phone/Fax

Practice location:
  • Phone: 304-263-0811
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number3029-IOD
License Number StateWV
# 2
Primary TaxonomyY
Taxonomy Code152WL0500X
TaxonomyLow Vision Rehabilitation Optometrist
License Number3029-IOD
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: