Provider Demographics
NPI:1073280517
Name:MURPHY, PAUL CAMILLUS
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:CAMILLUS
Last Name:MURPHY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3285 EMMA MARIE PL
Mailing Address - Street 2:
Mailing Address - City:BUFORD
Mailing Address - State:GA
Mailing Address - Zip Code:30519-7425
Mailing Address - Country:US
Mailing Address - Phone:404-863-2019
Mailing Address - Fax:
Practice Address - Street 1:3675 CRESTWOOD PKWY NW STE 472
Practice Address - Street 2:
Practice Address - City:DULUTH
Practice Address - State:GA
Practice Address - Zip Code:30096-5136
Practice Address - Country:US
Practice Address - Phone:762-436-6287
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-24
Last Update Date:2021-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician