Provider Demographics
NPI:1497804710
Name:MURRAY, PHILLIP JOHN (MD)
Entity Type:Individual
Prefix:DR
First Name:PHILLIP
Middle Name:JOHN
Last Name:MURRAY
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 1:380 SUMMIT AVE
Mailing Address - Street 2:
Mailing Address - City:STEUBENVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43952-2667
Mailing Address - Country:US
Mailing Address - Phone:740-283-7487
Mailing Address - Fax:740-284-4478
Practice Address - Street 1:380 SUMMIT AVE
Practice Address - Street 2:
Practice Address - City:STEUBENVILLE
Practice Address - State:OH
Practice Address - Zip Code:43952-2667
Practice Address - Country:US
Practice Address - Phone:740-283-7487
Practice Address - Fax:740-284-4478
Is Sole Proprietor?:No
Enumeration Date:2007-01-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-055234207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV12382OtherLICENSE
OH35-055234OtherLICENCE
A178608Medicare UPIN