Provider Demographics
NPI:1760476485
Name:MCMURTRY, CECIL E (MD)
Entity Type:Individual
Prefix:MR
First Name:CECIL
Middle Name:E
Last Name:MCMURTRY
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 1:113 E PUBLIC SQ
Mailing Address - Street 2:
Mailing Address - City:SCOTTSVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:42164-1440
Mailing Address - Country:US
Mailing Address - Phone:270-237-4899
Mailing Address - Fax:270-237-4466
Practice Address - Street 1:113 E PUBLIC SQ
Practice Address - Street 2:
Practice Address - City:SCOTTSVILLE
Practice Address - State:KY
Practice Address - Zip Code:42164-1440
Practice Address - Country:US
Practice Address - Phone:270-237-4899
Practice Address - Fax:270-237-4466
Is Sole Proprietor?:No
Enumeration Date:2005-09-08
Last Update Date:2010-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY28302207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY64283021Medicaid
KY64283021Medicaid
0381105Medicare ID - Type Unspecified