Provider Demographics
NPI:1013011535
Name:MURRAY, WILLIAM RANDALL (DC)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:RANDALL
Last Name:MURRAY
Suffix:
Gender:M
Credentials:DC
Other - Prefix:DR
Other - First Name:W.
Other - Middle Name:RANDALL
Other - Last Name:MURRAY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DC
Mailing Address - Street 1:10931 RAVEN RIDGE RD
Mailing Address - Street 2:SUITE 103
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27614-6499
Mailing Address - Country:US
Mailing Address - Phone:919-865-6900
Mailing Address - Fax:919-865-6902
Practice Address - Street 1:10931 RAVEN RIDGE RD
Practice Address - Street 2:SUITE 103
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27614-6499
Practice Address - Country:US
Practice Address - Phone:919-865-6900
Practice Address - Fax:919-865-6902
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2910111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
56-2255515OtherTAX ID
NC89085FCMedicaid
NC89085FCMedicaid
56-2255515OtherTAX ID