1205893880 NPI number — MICHAEL L MURPHY M.D.

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1205893880 NPI number — MICHAEL L MURPHY M.D.

Employer Identification Number (EIN):

Provider Organization Name:

Provider Last Name:

MURPHY

Provider First Name:

MICHAEL

Provider Middle Name:

L

Provider Name Prefix Text:

Provider Name Suffix Text:

Provider Credential Text:

M.D.

Provider Gender Code:

M

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:

1205893880

Entity Type Code:

Individual

Replacement NPI:

Last Update Date:

04/26/2017

NPI Deactivation Reason Code:

NPI Deactivation Date:

NPI Reactivation Date:

Provider First Line Business Mailing Address:

401 CASTLE CREEK RD

Provider Second Line Business Mailing Address:

Provider Business Mailing Address City Name:

ASPEN

Provider Business Mailing Address State Name:

CO

Provider Business Mailing Address Postal Code:

81611-1159

Provider Business Mailing Address Country Code:

US

Provider Business Mailing Address Telephone Number:

970-544-1460

Provider Business Mailing Address Fax Number:

Provider First Line Business Practice Location Address:

401 CASTLE CREEK RD

Provider Second Line Business Practice Location Address:

Provider Business Practice Location Address City Name:

ASPEN

Provider Business Practice Location Address State Name:

CO

Provider Business Practice Location Address Postal Code:

81611-1159

Provider Business Practice Location Address Country Code:

US

Provider Business Practice Location Address Telephone Number:

970-544-1460

Provider Business Practice Location Address Fax Number:

Provider Enumeration Date:

04/27/2006

Authorized Official Last Name:

Authorized Official First Name:

Authorized Official Middle Name:

Authorized Official Title or Position:

Authorized Official Telephone Number:

• Taxonomy code: 207W00000X , with the licence number:  33298-020 , registered in the state of WI ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
• Taxonomy code: 207WX0200X , with the licence number: 0057494 , registered in the state of CO ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

• Identifier: 103436 . This is a "HEALTH ALLIANCE" identifier , issued by the state of ( WI ) . This identifiers is of the category "OTHER".
• Identifier: 0800106 . This is a "UNITED HEALTHCARE" identifier , issued by the state of ( WI ) . This identifiers is of the category "OTHER".
• Identifier: 180033303 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( WI ) . This identifiers is of the category "OTHER".
• Identifier: 38608200 . This is a "ABRI" identifier , issued by the state of ( WI ) . This identifiers is of the category "OTHER".
• Identifier: 822601 . This is a "VIPA" identifier , issued by the state of ( WI ) . This identifiers is of the category "OTHER".
• Identifier: 5911421 . This is a "AETNA" identifier , issued by the state of ( WI ) . This identifiers is of the category "OTHER".
• Identifier: 391101335 . This is a "WI PHY SERVICE WPS" identifier , issued by the state of ( WI ) . This identifiers is of the category "OTHER".
• Identifier: 32306400 , issued by the state of ( WI ) . This identifiers is of the category "MEDICAID".
• Identifier: 747042 . This is a "MOHAWK" identifier , issued by the state of ( WI ) . This identifiers is of the category "OTHER".
• Identifier: 32306400 . This is a "MANAGED HEALTH SERVICES" identifier , issued by the state of ( WI ) . This identifiers is of the category "OTHER".
• Identifier: 391101335 . This is a "WI HEALTH INS RISK SHAR P" identifier , issued by the state of ( WI ) . This identifiers is of the category "OTHER".