Provider Demographics
NPI:1275639205
Name:MURTON, IAN BLAIR (MD)
Entity Type:Individual
Prefix:DR
First Name:IAN
Middle Name:BLAIR
Last Name:MURTON
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 1:7770 MORRO RD
Mailing Address - Street 2:
Mailing Address - City:ATASCADERO
Mailing Address - State:CA
Mailing Address - Zip Code:93422-4417
Mailing Address - Country:US
Mailing Address - Phone:805-461-1929
Mailing Address - Fax:805-461-5201
Practice Address - Street 1:7770 MORRO RD
Practice Address - Street 2:
Practice Address - City:ATASCADERO
Practice Address - State:CA
Practice Address - Zip Code:93422-4417
Practice Address - Country:US
Practice Address - Phone:805-461-1929
Practice Address - Fax:805-461-5201
Is Sole Proprietor?:No
Enumeration Date:2006-09-16
Last Update Date:2019-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA82807207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAWA82807AMedicare ID - Type UnspecifiedMEDICARE
CAH92460Medicare UPIN