Provider Demographics
NPI:1538896238
Name:TURNBULL, CHRISTOPHER JACKSON
Entity type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:JACKSON
Last Name:TURNBULL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:358 W COUNTRY SIDE DR
Mailing Address - Street 2:
Mailing Address - City:OREM
Mailing Address - State:UT
Mailing Address - Zip Code:84058-3037
Mailing Address - Country:US
Mailing Address - Phone:801-900-9686
Mailing Address - Fax:
Practice Address - Street 1:1951 MESQUITE AVE ST. F
Practice Address - Street 2:
Practice Address - City:LAKE HAVASU CITY
Practice Address - State:AZ
Practice Address - Zip Code:86403
Practice Address - Country:US
Practice Address - Phone:928-963-9333
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-02
Last Update Date:2024-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant