Provider Demographics
NPI:1295848323
Name:MURDOCK, JAMES W (DO)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:W
Last Name:MURDOCK
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 738
Mailing Address - Street 2:
Mailing Address - City:CLARKSVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72830-0738
Mailing Address - Country:US
Mailing Address - Phone:479-754-5454
Mailing Address - Fax:479-754-5311
Practice Address - Street 1:1100 E POPLAR ST
Practice Address - Street 2:
Practice Address - City:CLARKSVILLE
Practice Address - State:AR
Practice Address - Zip Code:72830-4419
Practice Address - Country:US
Practice Address - Phone:479-754-5454
Practice Address - Fax:479-754-5311
Is Sole Proprietor?:No
Enumeration Date:2006-08-15
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARN8223207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR55303OtherBX INDIVIDUAL PROVIDER #
AR121186003Medicaid
AR55303OtherBX INDIVIDUAL PROVIDER #
AR55303Medicare ID - Type UnspecifiedMCR INDIVIDUAL PROVIDER #