Provider Demographics
NPI:1629354436
Name:MURPHY, RICHARD SANDEFUR (DO)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:SANDEFUR
Last Name:MURPHY
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:12472 BREAKLINES ST
Mailing Address - Street 2:APT 402
Mailing Address - City:CARMEL
Mailing Address - State:IN
Mailing Address - Zip Code:46032-7661
Mailing Address - Country:US
Mailing Address - Phone:317-755-9460
Mailing Address - Fax:317-688-7871
Practice Address - Street 1:3266 N MERIDIAN STREET
Practice Address - Street 2:STE 101
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46208-5859
Practice Address - Country:US
Practice Address - Phone:317-925-0653
Practice Address - Fax:317-925-0774
Is Sole Proprietor?:No
Enumeration Date:2011-10-25
Last Update Date:2017-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN02004126A207Q00000X, 207QG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ININ1718002OtherMEDICARE PTAN
INM38018008OtherMEDICARE
IN201147510Medicaid