Provider Demographics
NPI:1659352920
Name:MURPHY III, JOHN E (DO)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:E
Last Name:MURPHY III
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6438 WILMINGTON PIKE
Mailing Address - Street 2:SUITE 110
Mailing Address - City:CENTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:45459-7010
Mailing Address - Country:US
Mailing Address - Phone:937-848-4121
Mailing Address - Fax:937-848-5965
Practice Address - Street 1:6438 WILMINGTON PIKE
Practice Address - Street 2:SUITE 110
Practice Address - City:CENTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:45459-7010
Practice Address - Country:US
Practice Address - Phone:937-848-4121
Practice Address - Fax:937-848-5965
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-14
Last Update Date:2009-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34002630207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0362432Medicaid
OHA77499Medicare UPIN
OH7327261Medicare ID - Type Unspecified