Provider Demographics
NPI:1710412754
Name:RICHARD S MURPHY DO LLC
Entity Type:Organization
Organization Name:RICHARD S MURPHY DO LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:S
Authorized Official - Last Name:MURPHY
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:317-755-9460
Mailing Address - Street 1:12472 BREAKLINES ST
Mailing Address - Street 2:APT 402
Mailing Address - City:CARMEL
Mailing Address - State:IN
Mailing Address - Zip Code:46032-7659
Mailing Address - Country:US
Mailing Address - Phone:317-755-9460
Mailing Address - Fax:
Practice Address - Street 1:12472 BREAKLINES ST
Practice Address - Street 2:APT 402
Practice Address - City:CARMEL
Practice Address - State:IN
Practice Address - Zip Code:46032-7659
Practice Address - Country:US
Practice Address - Phone:317-755-9460
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-27
Last Update Date:2017-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN02004126A207QH0002X, 207R00000X, 2084P0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207QH0002XAllopathic & Osteopathic PhysiciansFamily MedicineHospice and Palliative MedicineGroup - Multi-Specialty
No2084P0802XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyAddiction PsychiatryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN201147510Medicaid
INM38018008Medicare PIN