Provider Demographics
NPI:1457692204
Name:MURCHISON, MARCUS L
Entity Type:Individual
Prefix:MR
First Name:MARCUS
Middle Name:L
Last Name:MURCHISON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 220553
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99522-0553
Mailing Address - Country:US
Mailing Address - Phone:907-250-6758
Mailing Address - Fax:907-563-0994
Practice Address - Street 1:4211 COPE ST # 1
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99503-5727
Practice Address - Country:US
Practice Address - Phone:907-250-6758
Practice Address - Fax:907-563-0994
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-04
Last Update Date:2015-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
174H00000X
AK38295163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No174H00000XOther Service ProvidersHealth Educator