Provider Demographics
NPI:1417022260
Name:MURPHY DUFFY, CATHLEEN LOUISE (DO)
Entity Type:Individual
Prefix:
First Name:CATHLEEN
Middle Name:LOUISE
Last Name:MURPHY DUFFY
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:CATHLEEN
Other - Middle Name:LOUISE
Other - Last Name:MURPHY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:625 AFRICA RD STE 220
Mailing Address - Street 2:
Mailing Address - City:WESTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43082-9830
Mailing Address - Country:US
Mailing Address - Phone:614-882-2349
Mailing Address - Fax:614-882-9005
Practice Address - Street 1:625 AFRICA RD STE 220
Practice Address - Street 2:
Practice Address - City:WESTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:43082-9830
Practice Address - Country:US
Practice Address - Phone:614-882-2349
Practice Address - Fax:614-882-9005
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-21
Last Update Date:2019-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34008263207Q00000X
OH34.008263207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2596838Medicaid
OH2596838Medicaid
MU4150012Medicare PIN
J23980Medicare UPIN
4150011Medicare ID - Type Unspecified