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General NPI Number Information
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NPI Number | 1194857813
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Entity Type | Individual
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Provider Name | TIMOTHY TURCO PHD
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Gender | Male
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Dates
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Enumeration Date | 03/09/2007
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Last Update Date | 09/14/2011
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Provider Practice Location Address
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Address Line | 107 BROAD ST.
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City | PINE MOUNTAIN
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State | GA
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Zip | 31822
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Country | US
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Telephone | 706-457-7673
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Fax |
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Provider Business Mailing Address
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Address Line | 1048 MOUNTAIN VIEW WAY
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City | PINE MOUNTAIN
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State | GA
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Zip | 31822-2546
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Country | US
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Telephone | 706-457-7673
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | PSY002346
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License Number State | GA
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