Provider Demographics
NPI:1619925138
Name:MURPHY, MARK R (MD)
Entity Type:Individual
Prefix:
First Name:MARK
Middle Name:R
Last Name:MURPHY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:1515 N FLAGLER DR
Mailing Address - Street 2:STE 600
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33401-3428
Mailing Address - Country:US
Mailing Address - Phone:561-659-2266
Mailing Address - Fax:561-659-7846
Practice Address - Street 1:1515 N FLAGLER DR
Practice Address - Street 2:STE 600
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33401-3428
Practice Address - Country:US
Practice Address - Phone:561-659-2266
Practice Address - Fax:561-659-7846
Is Sole Proprietor?:No
Enumeration Date:2006-05-05
Last Update Date:2011-01-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME91139207YX0905X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207YX0905XAllopathic & Osteopathic PhysiciansOtolaryngologyOtolaryngology/Facial Plastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
I21307Medicare UPIN
50419ZMedicare ID - Type Unspecified