Provider Demographics
NPI:1477723906
Name:MURPHY, BRYAN DANIEL (OD)
Entity Type:Individual
Prefix:DR
First Name:BRYAN
Middle Name:DANIEL
Last Name:MURPHY
Suffix:
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 1:500 FAUNCE CORNER RD 110
Mailing Address - Street 2:
Mailing Address - City:NORTH DARTMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02747-1255
Mailing Address - Country:US
Mailing Address - Phone:508-717-0270
Mailing Address - Fax:508-717-0268
Practice Address - Street 1:500 FAUNCE CORNER RD
Practice Address - Street 2:SUITE 110
Practice Address - City:N DARTMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02747-1278
Practice Address - Country:US
Practice Address - Phone:508-717-0270
Practice Address - Fax:508-717-0268
Is Sole Proprietor?:No
Enumeration Date:2008-03-12
Last Update Date:2023-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA4670152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0723479Medicaid
MAW17655Medicare PIN
MAV10807Medicare UPIN