Provider Demographics
NPI:1215223235
Name:MURPHY, JESSE (DPM)
Entity Type:Individual
Prefix:DR
First Name:JESSE
Middle Name:
Last Name:MURPHY
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8127 MERRILLVILLE RD STE 4
Mailing Address - Street 2:
Mailing Address - City:MERRILLVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46410-6306
Mailing Address - Country:US
Mailing Address - Phone:219-736-8915
Mailing Address - Fax:219-736-8928
Practice Address - Street 1:303 W 89TH AVE
Practice Address - Street 2:SUITE E-1
Practice Address - City:MERRILLVILLE
Practice Address - State:IN
Practice Address - Zip Code:46410-6294
Practice Address - Country:US
Practice Address - Phone:219-736-8915
Practice Address - Fax:219-736-8928
Is Sole Proprietor?:No
Enumeration Date:2011-06-28
Last Update Date:2019-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN07001181A213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery