Provider Demographics
NPI:1356436992
Name:TURKIN, THOMAS C (DPM)
Entity type:Individual
Prefix:
First Name:THOMAS
Middle Name:C
Last Name:TURKIN
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7990 GRAND RIVER RD
Mailing Address - Street 2:
Mailing Address - City:BRIGHTON
Mailing Address - State:MI
Mailing Address - Zip Code:48114-7326
Mailing Address - Country:US
Mailing Address - Phone:810-227-3864
Mailing Address - Fax:810-227-3865
Practice Address - Street 1:7990 GRAND RIVER RD
Practice Address - Street 2:
Practice Address - City:BRIGHTON
Practice Address - State:MI
Practice Address - Zip Code:48114-7326
Practice Address - Country:US
Practice Address - Phone:810-227-3864
Practice Address - Fax:810-227-3865
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-03
Last Update Date:2009-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MITT000827213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI2093528Medicaid
MI485475609OtherBLUE CROSS BLUE SHIELD
MI2093528Medicaid
T34032Medicare UPIN