Provider Demographics
NPI:1336304252
Name:MURTAUGH, KEVIN H (MD)
Entity Type:Individual
Prefix:
First Name:KEVIN
Middle Name:H
Last Name:MURTAUGH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:702 N BLACKHAWK AVE #100
Mailing Address - Street 2:MADISON PSYCHIATRIC AND PSYCHOLOGICAL SERVICES
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53705-3357
Mailing Address - Country:US
Mailing Address - Phone:608-663-5926
Mailing Address - Fax:608-663-5928
Practice Address - Street 1:702 N BLACKHAWK AVE #100
Practice Address - Street 2:MADISON PSYCHIATRIC & PSYCHOLOGICAL SERVICES
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53705-3357
Practice Address - Country:US
Practice Address - Phone:608-663-5926
Practice Address - Fax:608-663-5928
Is Sole Proprietor?:No
Enumeration Date:2008-07-21
Last Update Date:2012-03-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WI53981-202084P0800X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program