Provider Demographics
NPI:1609925528
Name:MCMURRY, FREDDY GLENN (MD)
Entity Type:Individual
Prefix:DR
First Name:FREDDY
Middle Name:GLENN
Last Name:MCMURRY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:6767 OLD MADISON PIKE NW
Mailing Address - Street 2:BUILDING 4, SUITE 400
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35806-2172
Mailing Address - Country:US
Mailing Address - Phone:256-922-6675
Mailing Address - Fax:256-922-6660
Practice Address - Street 1:1615 KATHY LN SW
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:AL
Practice Address - Zip Code:35603-1026
Practice Address - Country:US
Practice Address - Phone:256-353-4325
Practice Address - Fax:256-353-9639
Is Sole Proprietor?:No
Enumeration Date:2007-01-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AL139372083X0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALC73745Medicare UPIN