Provider Demographics
NPI:1568784734
Name:JENNIFER L. H. MURPHY, O.D., P.A.
Entity Type:Organization
Organization Name:JENNIFER L. H. MURPHY, O.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:MURPHY
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:919-562-4254
Mailing Address - Street 1:25 BUFFALO RD
Mailing Address - Street 2:
Mailing Address - City:YOUNGSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27596-8782
Mailing Address - Country:US
Mailing Address - Phone:919-562-4254
Mailing Address - Fax:
Practice Address - Street 1:4601 GLENWOOD AVE
Practice Address - Street 2:SEARS OPTICAL
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27612-3809
Practice Address - Country:US
Practice Address - Phone:919-789-8253
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-15
Last Update Date:2011-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1916152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC592055860OtherTRICARE
NC2473699AMedicare PIN