Provider Demographics
NPI:1942272588
Name:MURPHY, MARY ANNE CATHERINE (OD)
Entity Type:Individual
Prefix:DR
First Name:MARY ANNE
Middle Name:CATHERINE
Last Name:MURPHY
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:13605 XAVIER LN
Mailing Address - Street 2:SUITE G
Mailing Address - City:BROOMFIELD
Mailing Address - State:CO
Mailing Address - Zip Code:80023-3603
Mailing Address - Country:US
Mailing Address - Phone:303-951-1820
Mailing Address - Fax:303-951-1826
Practice Address - Street 1:13605 XAVIER LN
Practice Address - Street 2:SUITE G
Practice Address - City:BROOMFIELD
Practice Address - State:CO
Practice Address - Zip Code:80023-3603
Practice Address - Country:US
Practice Address - Phone:303-951-1820
Practice Address - Fax:303-951-1826
Is Sole Proprietor?:No
Enumeration Date:2006-02-07
Last Update Date:2009-10-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CO2300152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
COC805688Medicare PIN
COU91861Medicare UPIN
CO6078930002Medicare NSC