Provider Demographics
NPI:1235590464
Name:MURPHY, KELVIN II (IDC)
Entity Type:Individual
Prefix:
First Name:KELVIN
Middle Name:
Last Name:MURPHY
Suffix:II
Gender:M
Credentials:IDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:UNIT 100332 BOX 1
Mailing Address - Street 2:USS TRUXTON DDG 103
Mailing Address - City:FPO
Mailing Address - State:AE
Mailing Address - Zip Code:09588-3200
Mailing Address - Country:US
Mailing Address - Phone:757-445-6164
Mailing Address - Fax:
Practice Address - Street 1:USS TRUXTON
Practice Address - Street 2:UNIT 100332 BOX 1
Practice Address - City:FPO
Practice Address - State:AE
Practice Address - Zip Code:09588-1309
Practice Address - Country:US
Practice Address - Phone:757-445-6164
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-16
Last Update Date:2016-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1710I1002XOther Service ProvidersMilitary Health Care ProviderIndependent Duty Corpsman