Provider Demographics
NPI:1043386881
Name:MURPHY, ANGELA W (DPM)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:W
Last Name:MURPHY
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 681207
Mailing Address - Street 2:
Mailing Address - City:FORT PAYNE
Mailing Address - State:AL
Mailing Address - Zip Code:35968-1613
Mailing Address - Country:US
Mailing Address - Phone:256-845-3045
Mailing Address - Fax:256-845-3046
Practice Address - Street 1:2202 JORDAN RD SW STE 500A
Practice Address - Street 2:
Practice Address - City:FORT PAYNE
Practice Address - State:AL
Practice Address - Zip Code:35968-3691
Practice Address - Country:US
Practice Address - Phone:256-845-3045
Practice Address - Fax:256-845-3046
Is Sole Proprietor?:No
Enumeration Date:2006-11-24
Last Update Date:2020-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL153213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL51509634OtherBCBS
U55995Medicare UPIN
051551756Medicare ID - Type Unspecified