1568437085 NPI number — DR. LINDA LAWRENCE MURPHY MD

Table of content: DAVID AULD MD (NPI 1881039055)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1568437085 NPI number — DR. LINDA LAWRENCE MURPHY MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
LAWRENCE MURPHY
Provider First Name:
LINDA
Provider Middle Name:
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
LAWRENCE
Provider Other First Name:
LINDA
Provider Other Middle Name:
L
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
MD
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1568437085
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/26/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5121 FLUSHING RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
FLUSHING
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
48433-2571
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
810-733-6184
Provider Business Mailing Address Fax Number:
810-733-7667

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
501 S BALLENGER HWY STE B
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FLINT
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48532-3606
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
810-342-4819
Provider Business Practice Location Address Fax Number:
810-733-7667
Provider Enumeration Date:
02/19/2006

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: 2085R0202X , with the licence number:  4301042471 , registered in the state of MI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 300B560780 . This is a "BCBS OF MICHIGAN" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 4362170 , issued by the state of ( MI ) . This identifiers is of the category "MEDICAID".
  • Identifier: 300F318310 . This is a "BCBS OF MICHIGAN" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 300B563870 . This is a "BCBS OF MICHIGAN" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 4345080 , issued by the state of ( MI ) . This identifiers is of the category "MEDICAID".
  • Identifier: 3279927 , issued by the state of ( MI ) . This identifiers is of the category "MEDICAID".
  • Identifier: 300089231 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 3279918 , issued by the state of ( MI ) . This identifiers is of the category "MEDICAID".
  • Identifier: 3279945 , issued by the state of ( MI ) . This identifiers is of the category "MEDICAID".
  • Identifier: 4272680 , issued by the state of ( MI ) . This identifiers is of the category "MEDICAID".
  • Identifier: 4280154 , issued by the state of ( MI ) . This identifiers is of the category "MEDICAID".




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