1487764890 NPI number — CHRISTOPHER MURPHY M.D.

Table of content: CHRISTOPHER MURPHY M.D. (NPI 1487764890)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1487764890 NPI number — CHRISTOPHER MURPHY M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MURPHY
Provider First Name:
CHRISTOPHER
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1487764890
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/16/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 144333
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ORLANDO
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
32814-4333
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
407-422-9831
Provider Business Mailing Address Fax Number:
407-206-1767

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
211 S 3RD ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BELLEVILLE
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
62220-1915
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
618-234-2120
Provider Business Practice Location Address Fax Number:
618-222-4630
Provider Enumeration Date:
08/30/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207ZP0102X , with the licence number:  036099524 , registered in the state of IL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 207ZP0213X , with the licence number: 036099524 , registered in the state of IL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 200886160 , issued by the state of ( IN ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1100112 . This is a "UHC MEDICARE COMPLETE" identifier . This identifiers is of the category "OTHER".
  • Identifier: H20423 . This is a "MERCY HEALTH PLAN" identifier . This identifiers is of the category "OTHER".
  • Identifier: 036099524 , issued by the state of ( IL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 220030932 . This is a "RAILROAD MEDICARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 238230 . This is a "HARMONY HEALTH" identifier , issued by the state of ( IL ) . This identifiers is of the category "OTHER".
  • Identifier: 5811655 . This is a "AETNA" identifier . This identifiers is of the category "OTHER".




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