Basic Information
Provider Information
NPI: 1689251613
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: TURK
FirstName: ROBBY
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 3869 MIRAMAR ST.
Address2: MAILBOX 3020
City: LA JOLLA
State: CA
PostalCode: 92037
CountryCode: US
TelephoneNumber: 3039499124
FaxNumber:  
Practice Location
Address1: 1025 MOREHEAD MEDICAL DR.
Address2: SUITE 300
City: CHARLOTTE
State: NC
PostalCode: 282042966
CountryCode: US
TelephoneNumber: 7044462772
FaxNumber:  
Other Information
ProviderEnumerationDate: 03/25/2021
LastUpdateDate: 03/25/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 03/24/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207X00000XTURK-3W08GHNCY Allopathic & Osteopathic PhysiciansOrthopaedic Surgery 

No ID Information.


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