MEDICARE: DAVID THOMAS TURTLE 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	VUT005265	NY

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	0597890003	OTHER	NY	MEDICARE DME
5	0597890001	OTHER	NY	MEDICARE DME
10	0597890002	OTHER	NY	MEDICARE DME
11	0597890004	OTHER	NY	MEDICARE DME

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	000300010007	OTHER	BCBS
2	000300010003	OTHER	BCBS
4	000300010001	OTHER	BCBS
6	NY5265	OTHER	EYEMED
7	7209479	OTHER	INDEPENDENT HEALTH
8	7309539	OTHER	INDEPENDENT HEALTH
9	00025972201	OTHER	UNIVERA
12	000300010005	OTHER	BCBS

General Provider Information

NPI Number	:	1134124704
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAVID THOMAS TURTLE O.D.

Provider Business Mailing Address
First Line	:	444 PAYNE AVE
Second Line	:
City	:	NORTH TONAWANDA
State	:	NY
Zip	:	14120-6902
Country	:	US
Telephone Number	:	716-693-1280
Fax Number	:	716-693-1383

Provider Business Practice Location Address
First Line	:	444 PAYNE AVE
Second Line	:
City	:	NORTH TONAWANDA
State	:	NY
Zip	:	14120-6902
Country	:	US
Telephone Number	:	716-693-1280
Fax Number	:	716-693-1383

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

Provider Enumeration Date	:	06/20/2005
Last Update Date	:	11/23/2007

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