Provider Demographics
NPI:1689781015
Name:MURPHY, PHILIP E (PHD)
Entity Type:Individual
Prefix:
First Name:PHILIP
Middle Name:E
Last Name:MURPHY
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5279 SYCAMORE GROVE LN
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38120-2241
Mailing Address - Country:US
Mailing Address - Phone:901-854-8707
Mailing Address - Fax:
Practice Address - Street 1:3238 PLAYERS CLUB CIR
Practice Address - Street 2:SUITE 65
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38125-8843
Practice Address - Country:US
Practice Address - Phone:800-632-6074
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-23
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNP1402103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3682179Medicaid
TN3682177Medicare ID - Type UnspecifiedINDIVIDUAL PROVIDER #
TN3682179Medicaid