MEDICARE: DR. LISA HAND TURBEVILLE 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	968	SC
2	152W00000X	Optometrist	1428	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1720072325
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LISA HAND TURBEVILLE O.D.

Provider Business Mailing Address
First Line	:	264 SHOREWARD DR
Second Line	:
City	:	MYRTLE BEACH
State	:	SC
Zip	:	29579-5146
Country	:	US
Telephone Number	:	843-236-2020
Fax Number	:	843-650-2525

Provider Business Practice Location Address
First Line	:	1651 GLENNS BAY RD
Second Line	:
City	:	SURFSIDE BEACH
State	:	SC
Zip	:	29575-4836
Country	:	US
Telephone Number	:	843-650-2400
Fax Number	:	843-650-2525

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

Provider Enumeration Date	:	09/09/2005
Last Update Date	:	07/08/2007

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