Provider Demographics
NPI:1326019712
Name:MURPHY, MARK A (MD)
Entity Type:Individual
Prefix:
First Name:MARK
Middle Name:A
Last Name:MURPHY
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 1:1852 BELTLINE RD SW
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:AL
Mailing Address - Zip Code:35601-5578
Mailing Address - Country:US
Mailing Address - Phone:256-340-9553
Mailing Address - Fax:256-340-9895
Practice Address - Street 1:1852 BELTLINE RD SW
Practice Address - Street 2:SUITE G
Practice Address - City:DECATUR
Practice Address - State:AL
Practice Address - Zip Code:35601-5578
Practice Address - Country:US
Practice Address - Phone:256-340-9553
Practice Address - Fax:256-340-9895
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-01
Last Update Date:2016-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL21871207L00000X, 208VP0014X, 208VP0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain Medicine
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL051553985Medicaid
ALD06587Medicare UPIN
AL051553985Medicaid