Provider Demographics
NPI:1861507196
Name:MURLEY, ERIN BETH (OD)
Entity Type:Individual
Prefix:DR
First Name:ERIN
Middle Name:BETH
Last Name:MURLEY
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 DRAWBRIDGE CT
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:IN
Mailing Address - Zip Code:47905-7812
Mailing Address - Country:US
Mailing Address - Phone:765-448-1130
Mailing Address - Fax:
Practice Address - Street 1:4205 COMMERCE DR
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:IN
Practice Address - Zip Code:47905-3800
Practice Address - Country:US
Practice Address - Phone:765-446-0058
Practice Address - Fax:765-446-1331
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN18002636152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
INU55330Medicare UPIN
IN809840Medicare ID - Type Unspecified