Provider Demographics
NPI:1801010772
Name:MURPHY WATSON BURR EYE CENTER, INC.
Entity Type:Organization
Organization Name:MURPHY WATSON BURR EYE CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:E
Authorized Official - Last Name:BURR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:816-233-2020
Mailing Address - Street 1:5202 FARAON
Mailing Address - Street 2:
Mailing Address - City:SAINT JOSEPH
Mailing Address - State:MO
Mailing Address - Zip Code:64506-3840
Mailing Address - Country:US
Mailing Address - Phone:816-233-2020
Mailing Address - Fax:816-279-4662
Practice Address - Street 1:610 LANA DRIVE
Practice Address - Street 2:
Practice Address - City:CAMERON
Practice Address - State:MO
Practice Address - Zip Code:64429-1585
Practice Address - Country:US
Practice Address - Phone:816-233-2020
Practice Address - Fax:816-279-4662
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-12
Last Update Date:2018-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOMD R7N30332H00000X
332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO328553003Medicaid
MOG33390Medicare UPIN
MOC51577Medicare UPIN
MOU97970Medicare UPIN
MOU78838Medicare UPIN
MO0783060001Medicare ID - Type UnspecifiedNORIDIAN ADMINISTRATORS