Provider Demographics
NPI:1710998174
Name:MURPHY, WILSON DARELL (MD)
Entity Type:Individual
Prefix:DR
First Name:WILSON
Middle Name:DARELL
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 1:100 MUNICIPAL DR
Mailing Address - Street 2:ETMC - CEDAR CREEK LAKE
Mailing Address - City:GUN BARREL CITY
Mailing Address - State:TX
Mailing Address - Zip Code:75156-3702
Mailing Address - Country:US
Mailing Address - Phone:903-713-1511
Mailing Address - Fax:
Practice Address - Street 1:100 MUNICIPAL DR
Practice Address - Street 2:ETMC - CEDAR CREEK LAKE
Practice Address - City:GUN BARREL CITY
Practice Address - State:TX
Practice Address - Zip Code:75156-3702
Practice Address - Country:US
Practice Address - Phone:903-713-1511
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-11
Last Update Date:2014-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXD9586207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
D62139Medicare UPIN