Provider Demographics
NPI:1649211186
Name:MURPHY, THOMAS LESLIE (MD)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:LESLIE
Last Name:MURPHY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:3833 COON RAPIDS BLVD NW
Mailing Address - Street 2:SUITE 100
Mailing Address - City:COON RAPIDS
Mailing Address - State:MN
Mailing Address - Zip Code:55433-2697
Mailing Address - Country:US
Mailing Address - Phone:763-427-8320
Mailing Address - Fax:763-302-4338
Practice Address - Street 1:3833 COON RAPIDS BLVD NW
Practice Address - Street 2:SUITE 100
Practice Address - City:COON RAPIDS
Practice Address - State:MN
Practice Address - Zip Code:55433-2697
Practice Address - Country:US
Practice Address - Phone:763-427-8320
Practice Address - Fax:763-302-4338
Is Sole Proprietor?:No
Enumeration Date:2006-06-08
Last Update Date:2011-12-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MN259492084N0400X
WI317722084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN0519222OtherMEDICA
MN130006224OtherRAILROAD MEDICARE
WI31582000Medicaid
MN0265037OtherPREFERRED ONE
MN22678OtherAMERICA'S PPO
MNHP14024OtherHEALTHPARTNERS
MN100293C029OtherUCARE
MN36834MUOtherBCBS OF MN
MN326802100Medicaid
MN0265037OtherPREFERRED ONE
MN0519222OtherMEDICA