Provider Demographics
NPI:1013989284
Name:MURPHY, JONATHAN ROBERT (OD)
Entity Type:Individual
Prefix:DR
First Name:JONATHAN
Middle Name:ROBERT
Last Name:MURPHY
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:265 S HOUCKS RD
Mailing Address - Street 2:
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17109-2907
Mailing Address - Country:US
Mailing Address - Phone:717-564-7015
Mailing Address - Fax:717-564-7189
Practice Address - Street 1:265 S HOUCKS RD
Practice Address - Street 2:
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17109-2907
Practice Address - Country:US
Practice Address - Phone:717-564-7015
Practice Address - Fax:717-564-7189
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-02
Last Update Date:2023-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG001471152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA085502VFNMedicare PIN
PAV02389Medicare UPIN
PA5742340001Medicare NSC