Provider Demographics
NPI:1518926112
Name:MURPHY, EDWARD ELIAS III (MD)
Entity Type:Individual
Prefix:DR
First Name:EDWARD
Middle Name:ELIAS
Last Name:MURPHY
Suffix:III
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 1:101 W MCKINLEY AVE
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:IL
Mailing Address - Zip Code:62526-3286
Mailing Address - Country:US
Mailing Address - Phone:217-876-3682
Mailing Address - Fax:217-876-3345
Practice Address - Street 1:101 W MCKINLEY AVE
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:IL
Practice Address - Zip Code:62526-3286
Practice Address - Country:US
Practice Address - Phone:217-876-3682
Practice Address - Fax:217-876-3345
Is Sole Proprietor?:No
Enumeration Date:2006-03-22
Last Update Date:2022-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036093790207KA0200X
MO103159207KA0200X
OK31197207KA0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207KA0200XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyAllergy
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036093790Medicaid
IL036093790Medicaid
MO000000597Medicare PIN