Provider Demographics
NPI:1558409490
Name:GREEN, MURPHY (MD)
Entity Type:Individual
Prefix:
First Name:MURPHY
Middle Name:
Last Name:GREEN
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 1:402 E CLOVER ST
Mailing Address - Street 2:
Mailing Address - City:HARLAN
Mailing Address - State:KY
Mailing Address - Zip Code:40831-2312
Mailing Address - Country:US
Mailing Address - Phone:606-573-3700
Mailing Address - Fax:606-573-6128
Practice Address - Street 1:402 E CLOVER ST
Practice Address - Street 2:
Practice Address - City:HARLAN
Practice Address - State:KY
Practice Address - Zip Code:40831-2312
Practice Address - Country:US
Practice Address - Phone:606-573-4820
Practice Address - Fax:606-573-6128
Is Sole Proprietor?:No
Enumeration Date:2007-02-02
Last Update Date:2013-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY170162083P0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY0275310Medicare ID - Type Unspecified