Provider Demographics
NPI:1922298488
Name:MURRAY, LEWIS VIRGIL IV (MD)
Entity Type:Individual
Prefix:DR
First Name:LEWIS
Middle Name:VIRGIL
Last Name:MURRAY
Suffix:IV
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:1717 OAK PARK BLVD
Mailing Address - Street 2:SUITE 1
Mailing Address - City:LAKE CHARLES
Mailing Address - State:LA
Mailing Address - Zip Code:70601-8991
Mailing Address - Country:US
Mailing Address - Phone:337-478-3810
Mailing Address - Fax:
Practice Address - Street 1:1717 OAK PARK BLVD
Practice Address - Street 2:SUITE 1
Practice Address - City:LAKE CHARLES
Practice Address - State:LA
Practice Address - Zip Code:70601-8991
Practice Address - Country:US
Practice Address - Phone:337-478-3810
Practice Address - Fax:337-478-6360
Is Sole Proprietor?:No
Enumeration Date:2007-07-30
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
LAMD.200341207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA35218OtherBOARD OF PHARMACY CDS
LA1067644Medicaid
LA1067644Medicaid