Provider Demographics
NPI:1477545770
Name:MURRAY, DANIEL EDWARD JR (OD)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:EDWARD
Last Name:MURRAY
Suffix:JR
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:550 JOHN D ODOM RD
Mailing Address - Street 2:
Mailing Address - City:DOTHAN
Mailing Address - State:AL
Mailing Address - Zip Code:36303-9461
Mailing Address - Country:US
Mailing Address - Phone:334-699-5999
Mailing Address - Fax:334-479-0631
Practice Address - Street 1:550 JOHN D ODOM RD
Practice Address - Street 2:
Practice Address - City:DOTHAN
Practice Address - State:AL
Practice Address - Zip Code:36303-9461
Practice Address - Country:US
Practice Address - Phone:334-699-5999
Practice Address - Fax:334-479-0631
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-22
Last Update Date:2023-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALS900TA450152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL51044874OtherBLUE CROSS BLUE SHIELD
AL000044874Medicaid
AL000044874Medicaid
ALU71926Medicare UPIN