Provider Demographics
NPI:1295963742
Name:MURPHY S. MARTIN, M.D., PLLC
Entity type:Organization
Organization Name:MURPHY S. MARTIN, M.D., PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:AMY
Authorized Official - Middle Name:
Authorized Official - Last Name:GRISSETT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:601-944-1717
Mailing Address - Street 1:PO BOX 3727
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:MS
Mailing Address - Zip Code:39207-3727
Mailing Address - Country:US
Mailing Address - Phone:601-326-3900
Mailing Address - Fax:601-326-3903
Practice Address - Street 1:1600 N STATE ST
Practice Address - Street 2:SUITE 110
Practice Address - City:JACKSON
Practice Address - State:MS
Practice Address - Zip Code:39202-1689
Practice Address - Country:US
Practice Address - Phone:601-326-3900
Practice Address - Fax:601-326-3903
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-23
Last Update Date:2009-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS13968207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Single Specialty