Phillip T Deturk (NPI# 1275626095, PAC ID# 4082785704) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is NURSE PRACTITIONER.
| Nation Provider ID (NPI) | 1275626095 |
| PAC ID by PECOS | 4082785704 |
| Professional Enrollment ID | I20080624000018 |
| Full Name | Phillip T Deturk |
| Organization Legal Name | RANDALL DERMATOLOGY, PC |
| Address |
620 S Berkley Rd Kokomo IN 46902-5144 |
| Phone Number | 7654528602 |
| Gender | M |
| Graduation Year | 2006 |
| Primary Specialty | NURSE PRACTITIONER |
| Group Practice PAC ID | 3678675329 |
| Number of Group Practice Members | 9 |
| Accepts Medicare Assignment | Y |
| Address | Phone | Organization |
|---|---|---|
| 620 S Berkley Rd, Kokomo, IN 46902-5144 | 7654528602 | RANDALL DERMATOLOGY, PC |
| 1201 N Mckinley St, Rensselaer, IN 47978-2034 | 2198667124 | RANDALL DERMATOLOGY, PC |
| Organization Legal Name | RANDALL DERMATOLOGY, PC |
| Physicians | 9 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Lindsay S Wilson | Nurse Practitioner | Randall Dermatology, PC | 124 Sagamore Pkwy W, West Lafayette, IN 47906-1569 |
| Laura L Wavra | Nurse Practitioner | Randall Dermatology, PC | 1351 S Jackson St, Frankfort, IN 46041-3314 |
| Bradley C Hurliman | Physician Assistant | Randall Dermatology, PC | 1351 S Jackson St, Frankfort, IN 46041-3314 |
| Katrina N Masterson | Nurse Practitioner | Randall Dermatology, PC | 1351 S Jackson St, Frankfort, IN 46041-3314 |
| John K Randall | Dermatology | Randall Dermatology, PC | 620 S Berkley Rd, Kokomo, IN 46902-5144 |
| Mark Manning | Nurse Practitioner | Randall Dermatology, PC | 124 Sagamore Pkwy W, West Lafayette, IN 47906-1569 |
| Theresa E Coyner | Nurse Practitioner | Randall Dermatology, PC | 1351 S Jackson St, Frankfort, IN 46041-3314 |
| Holly Nicole Howe | Nurse Practitioner | Randall Dermatology, PC | 1351 S Jackson St, Frankfort, IN 46041-3314 |
| Street Address |
620 S BERKLEY RD |
| City | KOKOMO |
| State | IN |
| Zip | 46902-5144 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| John K Randall | Dermatology | Randall Dermatology, PC | 620 S Berkley Rd, Kokomo, IN 46902-5144 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Jeannette S Murphy | Clinical Social Worker | 1428 S Main St, Suite 2, Kokomo, IN 46902-1693 | |
| Dawn R Cassidy | Optometry | City Optical Co Inc | 1164 S 17th St, Dr Tavel Family Eye Care, Kokomo, IN 46902-1901 |
| Mark G Cutler | Optometry | Wisconsin Vision Inc | 2030 S Reed Rd, Heartland Vision, Kokomo, IN 46902-1905 |
| Frank Decleene Iii | Optometry | Decleene Optometry, Inc. | 608 E Boulevard, Kokomo, IN 46902-2271 |
| Travis Christopher Stephens | Optometry | Decleene Optometry, Inc. | 608 E Boulevard, Kokomo, IN 46902-2271 |
| Catherine Marie Decleene | Optometry | Decleene Optometry, Inc. | 608 E Boulevard, Kokomo, IN 46902-2271 |
| Dana Y Stewart | Pediatric Medicine | 700 E Firmin St, Suite 212, Kokomo, IN 46902-2375 | |
| Ann Swingle Lauri | Physical Therapy | Accelerated Rehabilitation Centers Ltd | 2108 E Boulevard, Kokomo, IN 46902-2401 |
| Christopher Markus | Physical Therapy | Accelerated Rehabilitation Centers Ltd. | 2108 E Blvd, Kokomo, IN 46902-2401 |
| Chad P Schumann | Physical Therapy | Accelerated Rehabilitation Centers Ltd | 2108 E Boulevard, Kokomo, IN 46902-2401 |
| Find all physicians in zip 46902 | |||
| City | KOKOMO |
| Zip Code | 46902 |
| Specialty | NURSE PRACTITIONER |
| City + Specialty | KOKOMO + NURSE PRACTITIONER |
Please comment or provide details below to improve the information on Phillip T Deturk.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.