Provider Demographics
NPI:1487681425
Name:MURPHY, TIMOTHY F (MD)
Entity Type:Individual
Prefix:DR
First Name:TIMOTHY
Middle Name:F
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 1:1555 N WASHINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:LUDINGTON
Mailing Address - State:MI
Mailing Address - Zip Code:49431-1009
Mailing Address - Country:US
Mailing Address - Phone:231-852-0459
Mailing Address - Fax:
Practice Address - Street 1:1555 N WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:LUDINGTON
Practice Address - State:MI
Practice Address - Zip Code:49431-1009
Practice Address - Country:US
Practice Address - Phone:231-852-0459
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-26
Last Update Date:2019-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301052832207VX0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VX0000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyObstetrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1604100411OtherBLUE CROSS BLUE SHIELD
MIF31034Medicare UPIN
MI0N65070Medicare PIN
MI7000000031OtherPRIORITY HEALTH
MI104483961Medicaid
MIP69389OtherBLUE CARE NETWORK