1902244387 NPI number — MURPHY QUALITY EYE CARE PC

Table of content: (NPI 1902244387)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1902244387 NPI number — MURPHY QUALITY EYE CARE PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MURPHY QUALITY EYE CARE PC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

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:
1902244387
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/31/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1403 DEVILS GLEN RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BETTENDORF
Provider Business Mailing Address State Name:
IA
Provider Business Mailing Address Postal Code:
52722
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
309-749-5550
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4756 ELMORE AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DAVENPORT
Provider Business Practice Location Address State Name:
IA
Provider Business Practice Location Address Postal Code:
52807
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
309-749-5550
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/07/2013

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
DUNNE
Authorized Official First Name:
KATHERINE
Authorized Official Middle Name:
LORETTA MURPHY
Authorized Official Title or Position:
OPTOMETRIST
Authorized Official Telephone Number:
309-749-5550

Provider Taxonomy Codes

  • Taxonomy code: 152W00000X , with the licence number:  002512 , registered in the state of IA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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