Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2084N0402X | Child Neurologist | 55402 | KY |
NPI | 1114380516 |
---|---|
Provider Name | Dr. Grant Joseph Turek |
First Address | Oak Park, IL 60304-1978 |
Second Address | Jeffersonville, IN 47130-7277 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/04/2016 |
Last Update Date | 13/06/2021 |