Provider Demographics
NPI:1578622759
Name:MURPHY CHIROPRACTIC PC
Entity Type:Organization
Organization Name:MURPHY CHIROPRACTIC PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ALEX
Authorized Official - Middle Name:ROTH
Authorized Official - Last Name:MURPHY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:712-668-2397
Mailing Address - Street 1:224 SOUTH MAIN STREET
Mailing Address - Street 2:PO BOX 469
Mailing Address - City:ODEBOLT
Mailing Address - State:IA
Mailing Address - Zip Code:51458
Mailing Address - Country:US
Mailing Address - Phone:712-668-2397
Mailing Address - Fax:712-668-2399
Practice Address - Street 1:224 S. MAIN ST.
Practice Address - Street 2:
Practice Address - City:ODEBOLT
Practice Address - State:IA
Practice Address - Zip Code:51458
Practice Address - Country:US
Practice Address - Phone:712-668-2397
Practice Address - Fax:712-668-2399
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA06540111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NS0005XChiropractic ProvidersChiropractorSports PhysicianGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0276972Medicaid
IA17838OtherWELLMARK BCBS
IA17838OtherWELLMARK BCBS
IA0276972Medicaid