Provider Demographics
NPI:1316203243
Name:MURPHY CANTU PSYCHIATRY GROUP LLC
Entity Type:Organization
Organization Name:MURPHY CANTU PSYCHIATRY GROUP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:A
Authorized Official - Last Name:MURPHY
Authorized Official - Suffix:III
Authorized Official - Credentials:MD
Authorized Official - Phone:337-794-2638
Mailing Address - Street 1:PO BOX 580
Mailing Address - Street 2:
Mailing Address - City:LAKE CHARLES
Mailing Address - State:LA
Mailing Address - Zip Code:70602-0580
Mailing Address - Country:US
Mailing Address - Phone:337-794-2638
Mailing Address - Fax:337-855-1829
Practice Address - Street 1:4501 AUTUMNWOOD LN
Practice Address - Street 2:
Practice Address - City:LAKE CHARLES
Practice Address - State:LA
Practice Address - Zip Code:70605-5453
Practice Address - Country:US
Practice Address - Phone:337-794-2638
Practice Address - Fax:337-855-1829
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-04
Last Update Date:2012-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA09455R2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA=========OtherEIN