Provider Demographics
NPI:1205893880
Name:MURPHY, MICHAEL L (MD)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:L
Last Name:MURPHY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 CASTLE CREEK RD
Mailing Address - Street 2:
Mailing Address - City:ASPEN
Mailing Address - State:CO
Mailing Address - Zip Code:81611-1159
Mailing Address - Country:US
Mailing Address - Phone:970-544-1460
Mailing Address - Fax:
Practice Address - Street 1:401 CASTLE CREEK RD
Practice Address - Street 2:
Practice Address - City:ASPEN
Practice Address - State:CO
Practice Address - Zip Code:81611-1159
Practice Address - Country:US
Practice Address - Phone:970-544-1460
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-27
Last Update Date:2017-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI33298-020207W00000X
CO0057494207WX0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207WX0200XAllopathic & Osteopathic PhysiciansOphthalmologyOphthalmic Plastic and Reconstructive Surgery
No207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI103436OtherHEALTH ALLIANCE
WI0800106OtherUNITED HEALTHCARE
WI180033303OtherRAILROAD MEDICARE
WI38608200OtherABRI
WI822601OtherVIPA
WI5911421OtherAETNA
WI391101335OtherWI PHY SERVICE WPS
WI32306400Medicaid
WI747042OtherMOHAWK
WI32306400OtherMANAGED HEALTH SERVICES
WI391101335OtherWI HEALTH INS RISK SHAR P
WI103436OtherHEALTH ALLIANCE
WI180033303OtherRAILROAD MEDICARE
WI000702660Medicare PIN