Provider Demographics
NPI:1801012547
Name:J.L. MURRAY, D.C.,P.A.
Entity Type:Organization
Organization Name:J.L. MURRAY, D.C.,P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JACK
Authorized Official - Middle Name:L
Authorized Official - Last Name:MURRAY
Authorized Official - Suffix:JR
Authorized Official - Credentials:DC
Authorized Official - Phone:301-722-4400
Mailing Address - Street 1:12 DECATUR ST
Mailing Address - Street 2:
Mailing Address - City:CUMBERLAND
Mailing Address - State:MD
Mailing Address - Zip Code:21502-2412
Mailing Address - Country:US
Mailing Address - Phone:301-722-4400
Mailing Address - Fax:301-722-5527
Practice Address - Street 1:12 DECATUR ST
Practice Address - Street 2:
Practice Address - City:CUMBERLAND
Practice Address - State:MD
Practice Address - Zip Code:21502-2412
Practice Address - Country:US
Practice Address - Phone:301-722-4400
Practice Address - Fax:301-722-5527
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-18
Last Update Date:2008-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDS01103111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDU03142Medicare UPIN
MD964LMedicare PIN