Provider Demographics
NPI:1417396599
Name:MURPHY, BRENT (DO)
Entity Type:Individual
Prefix:
First Name:BRENT
Middle Name:
Last Name:MURPHY
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5571 GRETNA RD
Mailing Address - Street 2:
Mailing Address - City:BRANSON
Mailing Address - State:MO
Mailing Address - Zip Code:65616-7287
Mailing Address - Country:US
Mailing Address - Phone:886-951-8387
Mailing Address - Fax:417-243-2390
Practice Address - Street 1:5571 GRETNA RD
Practice Address - Street 2:
Practice Address - City:BRANSON
Practice Address - State:MO
Practice Address - Zip Code:65616-7287
Practice Address - Country:US
Practice Address - Phone:886-951-8387
Practice Address - Fax:417-243-2390
Is Sole Proprietor?:No
Enumeration Date:2013-06-21
Last Update Date:2023-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2013018923207R00000X
MO2016010184207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine