Provider Demographics
NPI:1922204809
Name:RICHARD C MCCLURG, OD & WILLIAM MURRAY, OD LLC
Entity Type:Organization
Organization Name:RICHARD C MCCLURG, OD & WILLIAM MURRAY, OD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:WILLAIM
Authorized Official - Middle Name:D
Authorized Official - Last Name:MURRAY
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:614-837-7725
Mailing Address - Street 1:20 S HIGH ST
Mailing Address - Street 2:
Mailing Address - City:CANAL WINCHESTER
Mailing Address - State:OH
Mailing Address - Zip Code:43110-1251
Mailing Address - Country:US
Mailing Address - Phone:614-837-7725
Mailing Address - Fax:614-837-7301
Practice Address - Street 1:20 S HIGH ST
Practice Address - Street 2:
Practice Address - City:CANAL WINCHESTER
Practice Address - State:OH
Practice Address - Zip Code:43110-1251
Practice Address - Country:US
Practice Address - Phone:614-837-7725
Practice Address - Fax:614-837-7301
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-26
Last Update Date:2014-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH4577-152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0030933Medicaid
OH0030933Medicaid
OHU-53043Medicare UPIN
OH4701760001Medicare NSC
DC4383Medicare PIN