Provider Demographics
NPI:1780681312
Name:MURPHY, TIMOTHY P (MD)
Entity Type:Individual
Prefix:
First Name:TIMOTHY
Middle Name:P
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:PO BOX 6300
Mailing Address - Street 2:
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02940-6300
Mailing Address - Country:US
Mailing Address - Phone:401-274-0103
Mailing Address - Fax:
Practice Address - Street 1:56 COLPITTS RD
Practice Address - Street 2:
Practice Address - City:WESTON
Practice Address - State:MA
Practice Address - Zip Code:02493-1568
Practice Address - Country:US
Practice Address - Phone:781-891-0906
Practice Address - Fax:781-891-0912
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-28
Last Update Date:2010-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA156870207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
6026608OtherCIGNA HEALTH CARE
J19188OtherBLUE SHIELD-INDEMNITY
A29270OtherMEDICARE
J19188OtherHMO BLUE/BLUE CHOICE
68521OtherHARVARD PILGRIM POS
68521OtherHARVARD PILGRIM PPO
792377OtherTUFTS
792377OtherTUFTS COMMONWEALTH PPO
792377OtherTUFTS TOTAL HEALTH PLAN
68521OtherHARVARD/PILGRIM
792377OtherTUFTS BENEFIT ADMIN
792377OtherTUFTS COMMONWEALTH PPO