Provider Demographics
NPI:1720379696
Name:D L MURRAY MD PC
Entity Type:Organization
Organization Name:D L MURRAY MD PC
Other - Org Name:MURRAY MEDICAL & WELLNESS CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEDICAL DIRECTOR / PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DARRELL
Authorized Official - Middle Name:L
Authorized Official - Last Name:MURRAY
Authorized Official - Suffix:SR
Authorized Official - Credentials:MD
Authorized Official - Phone:404-549-9471
Mailing Address - Street 1:920 DANNON VW SW
Mailing Address - Street 2:SUITE 3103
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30331-2157
Mailing Address - Country:US
Mailing Address - Phone:404-549-9471
Mailing Address - Fax:404-549-9486
Practice Address - Street 1:920 DANNON VW SW
Practice Address - Street 2:SUITE 3103
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30331-2157
Practice Address - Country:US
Practice Address - Phone:404-549-9471
Practice Address - Fax:404-549-9486
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-27
Last Update Date:2011-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA044797207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA=========Medicaid