Provider Demographics
NPI:1922188002
Name:CHRISTOPHER B MURPHY PA
Entity Type:Organization
Organization Name:CHRISTOPHER B MURPHY PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:B
Authorized Official - Last Name:MURPHY
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:386-428-5656
Mailing Address - Street 1:107 MERRIMAC ST
Mailing Address - Street 2:
Mailing Address - City:EDGEWATER
Mailing Address - State:FL
Mailing Address - Zip Code:32132-1905
Mailing Address - Country:US
Mailing Address - Phone:386-428-5656
Mailing Address - Fax:386-428-5440
Practice Address - Street 1:107 MERRIMAC ST
Practice Address - Street 2:
Practice Address - City:EDGEWATER
Practice Address - State:FL
Practice Address - Zip Code:32132-1905
Practice Address - Country:US
Practice Address - Phone:386-428-5656
Practice Address - Fax:386-428-5440
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-16
Last Update Date:2010-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPO2338213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL390131900Medicaid
FLDN3423Medicare PIN
FLU45274Medicare UPIN
FL390131900Medicaid
FLAJ607Medicare PIN