Provider Demographics
NPI:1164178877
Name:MURDOCK, JAIMIE LEE (RPSGT)
Entity Type:Individual
Prefix:MRS
First Name:JAIMIE
Middle Name:LEE
Last Name:MURDOCK
Suffix:
Gender:F
Credentials:RPSGT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:135 N LAKESHORE DR
Mailing Address - Street 2:
Mailing Address - City:MANAHAWKIN
Mailing Address - State:NJ
Mailing Address - Zip Code:08050-2914
Mailing Address - Country:US
Mailing Address - Phone:434-515-3555
Mailing Address - Fax:
Practice Address - Street 1:135 N LAKESHORE DR
Practice Address - Street 2:
Practice Address - City:MANAHAWKIN
Practice Address - State:NJ
Practice Address - Zip Code:08050-2914
Practice Address - Country:US
Practice Address - Phone:434-515-3555
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-22
Last Update Date:2022-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156F00000XEye and Vision Services ProvidersTechnician/Technologist