Provider Demographics
NPI:1679557268
Name:MURPHY, JAMES T (MD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:T
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:PO BOX 327
Mailing Address - Street 2:
Mailing Address - City:BROOMFIELD
Mailing Address - State:CO
Mailing Address - Zip Code:80038-0327
Mailing Address - Country:US
Mailing Address - Phone:303-657-2763
Mailing Address - Fax:303-657-9023
Practice Address - Street 1:2489 KALMIA AVE
Practice Address - Street 2:
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80304-1965
Practice Address - Country:US
Practice Address - Phone:303-817-5953
Practice Address - Fax:720-565-1511
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-06
Last Update Date:2008-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO19868207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO01198688Medicaid
CO01198688Medicaid
D23678Medicare UPIN