Provider Demographics
NPI:1588802805
Name:MURDOCK, WILLIAM H
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:H
Last Name:MURDOCK
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1170
Mailing Address - Street 2:
Mailing Address - City:COOPERSTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:13326-6170
Mailing Address - Country:US
Mailing Address - Phone:607-547-8080
Mailing Address - Fax:607-547-2152
Practice Address - Street 1:5370 STATE HIGHWAY 28
Practice Address - Street 2:
Practice Address - City:COOPERSTOWN
Practice Address - State:NY
Practice Address - Zip Code:13326-5710
Practice Address - Country:US
Practice Address - Phone:607-547-8080
Practice Address - Fax:607-547-2152
Is Sole Proprietor?:No
Enumeration Date:2009-01-23
Last Update Date:2009-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY006843-1156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician