Provider Demographics
NPI:1629166707
Name:MURPHY, THOMAS EDMUND (MD)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:EDMUND
Last Name:MURPHY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3507 SKYLINE DR
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50310-5050
Mailing Address - Country:US
Mailing Address - Phone:515-274-1316
Mailing Address - Fax:
Practice Address - Street 1:3507 SKYLINE DR
Practice Address - Street 2:
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50310-5050
Practice Address - Country:US
Practice Address - Phone:515-274-1316
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA194962085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology