Provider Demographics
NPI:1134143084
Name:MURPHY, KATHLEEN A (OD)
Entity Type:Individual
Prefix:DR
First Name:KATHLEEN
Middle Name:A
Last Name:MURPHY
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:6285 EMERALD PKWY
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:OH
Mailing Address - Zip Code:43016-3241
Mailing Address - Country:US
Mailing Address - Phone:614-764-8956
Mailing Address - Fax:614-764-9532
Practice Address - Street 1:6285 EMERALD PKWY
Practice Address - Street 2:
Practice Address - City:DUBLIN
Practice Address - State:OH
Practice Address - Zip Code:43016-3241
Practice Address - Country:US
Practice Address - Phone:614-764-8956
Practice Address - Fax:614-764-9532
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-26
Last Update Date:2009-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3626152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHKA4269281Medicare PIN
OHT47720Medicare UPIN