Provider Demographics
NPI:1710901566
Name:MURPHY, TIMOTHY JOSEPH (MD)
Entity Type:Individual
Prefix:DR
First Name:TIMOTHY
Middle Name:JOSEPH
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 1:201 PRENTICE
Mailing Address - Street 2:
Mailing Address - City:EL JEBEL
Mailing Address - State:CO
Mailing Address - Zip Code:81623-9825
Mailing Address - Country:US
Mailing Address - Phone:970-963-0547
Mailing Address - Fax:775-418-8382
Practice Address - Street 1:201 PRENTICE
Practice Address - Street 2:
Practice Address - City:EL JEBEL
Practice Address - State:CO
Practice Address - Zip Code:81623-9825
Practice Address - Country:US
Practice Address - Phone:970-963-0547
Practice Address - Fax:775-418-8382
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-26
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO37688208D00000X
IA18046208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
E35033Medicare UPIN