Provider Demographics
NPI:1700841418
Name:MURRAY, CHRISTOPHER CLARK (DO)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:CLARK
Last Name:MURRAY
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:PO BOX 116700
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30368-6700
Mailing Address - Country:US
Mailing Address - Phone:904-236-5884
Mailing Address - Fax:
Practice Address - Street 1:8375 DIX ELLIS TRL
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32256-8273
Practice Address - Country:US
Practice Address - Phone:904-399-5550
Practice Address - Fax:904-346-4334
Is Sole Proprietor?:No
Enumeration Date:2006-04-18
Last Update Date:2023-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI51010117532085R0202X
MI151010117652085R0202X
FLOS191822085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIG18788Medicare UPIN
G18788Medicare UPIN
MI0B56294015Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER