Provider Demographics
NPI:1013121201
Name:JONATHAN B MURPHY MD INC
Entity Type:Organization
Organization Name:JONATHAN B MURPHY MD INC
Other - Org Name:NATURAL PATH HEALTH CENTER
Other - Org Type:Other Name
Authorized Official - Title/Position:CLINIC DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:B
Authorized Official - Last Name:MURPHY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:304-201-3600
Mailing Address - Street 1:201 6TH AVE
Mailing Address - Street 2:PO BOX 1518
Mailing Address - City:SAINT ALBANS
Mailing Address - State:WV
Mailing Address - Zip Code:25177
Mailing Address - Country:US
Mailing Address - Phone:304-201-3600
Mailing Address - Fax:304-201-2368
Practice Address - Street 1:201 6TH AVE
Practice Address - Street 2:
Practice Address - City:SAINT ALBANS
Practice Address - State:WV
Practice Address - Zip Code:25177
Practice Address - Country:US
Practice Address - Phone:304-201-3600
Practice Address - Fax:304-201-2368
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-09
Last Update Date:2007-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical OncologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV0072215000Medicaid
WV9333511Medicare PIN
WVE19540Medicare UPIN
WVDD3681Medicare PIN