Provider Demographics
NPI:1750504007
Name:LAURRIE MURPHY-KNIGHT MD
Entity Type:Organization
Organization Name:LAURRIE MURPHY-KNIGHT MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:LAURRIE
Authorized Official - Middle Name:
Authorized Official - Last Name:MURPHY-KNIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:313-831-8303
Mailing Address - Street 1:PO BOX 2290
Mailing Address - Street 2:
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48037-2290
Mailing Address - Country:US
Mailing Address - Phone:313-831-8303
Mailing Address - Fax:313-831-8307
Practice Address - Street 1:4160 JOHN R ST
Practice Address - Street 2:SUITE 729
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48201-2020
Practice Address - Country:US
Practice Address - Phone:313-831-8303
Practice Address - Fax:313-831-8307
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MILK059737207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4503142Medicaid
MI4503142Medicaid
MI4503142Medicaid
MI=========OtherTIN