Provider Demographics
NPI:1134109572
Name:MURRELL, WILLIAM D (MD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:D
Last Name:MURRELL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:815 COURT ST STE 4
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:CA
Mailing Address - Zip Code:95642-2154
Mailing Address - Country:US
Mailing Address - Phone:518-561-2000
Mailing Address - Fax:
Practice Address - Street 1:815 COURT ST STE 4
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:CA
Practice Address - Zip Code:95642-2154
Practice Address - Country:US
Practice Address - Phone:209-217-8416
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-20
Last Update Date:2023-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY227907207X00000X
COCDRH.0066414207X00000X, 207XX0005X
FLME155808207X00000X
SD5161207X00000X
CAA84674207XX0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports Medicine
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND12749Medicaid
SD4995849OtherS BCBS NUMBER
ND23665OtherND BX JAMESTOWN CLINIC
ND23666OtherND BX JAMESTOWN HOSP
ND25839OtherND BX OAKES ND HOSPITAL
ND25840OtherND BX OAKES CLINIC
SD5161OtherDAKOTACARE
SD6402190Medicaid
SD4995849OtherS BCBS NUMBER
ND23640Medicare ID - Type UnspecifiedND MEDICARE PROVIDER #
ND12749Medicaid
ND25840OtherND BX OAKES CLINIC
SDH25247Medicare UPIN