Provider Demographics
NPI:1407888357
Name:MURPHY, WAYNE (MD)
Entity Type:Individual
Prefix:
First Name:WAYNE
Middle Name:
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:PO BOX 1024
Mailing Address - Street 2:
Mailing Address - City:MURFREESBORO
Mailing Address - State:TN
Mailing Address - Zip Code:37133-1024
Mailing Address - Country:US
Mailing Address - Phone:615-898-0023
Mailing Address - Fax:615-898-0566
Practice Address - Street 1:745 S CHURCH ST
Practice Address - Street 2:SUITE 601
Practice Address - City:MURFREESBORO
Practice Address - State:TN
Practice Address - Zip Code:37130-4984
Practice Address - Country:US
Practice Address - Phone:615-898-0023
Practice Address - Fax:615-898-0566
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-07
Last Update Date:2009-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD0000018277207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNA99273Medicare UPIN
TN3028785Medicare ID - Type Unspecified