Provider Demographics
NPI:1295892537
Name:MURPHY, CHARLES M (MPT)
Entity type:Individual
Prefix:
First Name:CHARLES
Middle Name:M
Last Name:MURPHY
Suffix:
Gender:M
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22859 ADAMS DR
Mailing Address - Street 2:
Mailing Address - City:ROBERTSDALE
Mailing Address - State:AL
Mailing Address - Zip Code:36567-3610
Mailing Address - Country:US
Mailing Address - Phone:251-978-5805
Mailing Address - Fax:251-947-4825
Practice Address - Street 1:11741 COUNTY ROAD 54
Practice Address - Street 2:
Practice Address - City:DAPHNE
Practice Address - State:AL
Practice Address - Zip Code:36526-5416
Practice Address - Country:US
Practice Address - Phone:251-978-5805
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-03
Last Update Date:2017-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALPTH4052225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL515-27058OtherBCBS PROVIDER NUMBER