Provider Demographics
NPI:1336356922
Name:MURPHY, TIMOTHY JAMES (PHD)
Entity Type:Individual
Prefix:DR
First Name:TIMOTHY
Middle Name:JAMES
Last Name:MURPHY
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17 SUNSET CIR
Mailing Address - Street 2:
Mailing Address - City:BETTENDORF
Mailing Address - State:IA
Mailing Address - Zip Code:52722-6044
Mailing Address - Country:US
Mailing Address - Phone:563-322-7707
Mailing Address - Fax:563-322-7710
Practice Address - Street 1:718 BRIDGE AVE
Practice Address - Street 2:SUITE 8
Practice Address - City:DAVENPORT
Practice Address - State:IA
Practice Address - Zip Code:52803-5620
Practice Address - Country:US
Practice Address - Phone:563-322-7707
Practice Address - Fax:563-322-7710
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA00681103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA37062OtherBLUE CROSS BLUE SHIELD