Provider Demographics
NPI:1639144249
Name:HANLEY, RICHARD MURPHY (DPM)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:MURPHY
Last Name:HANLEY
Suffix:
Gender:M
Credentials:DPM
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 10565
Mailing Address - Street 2:
Mailing Address - City:WINTER HAVEN
Mailing Address - State:FL
Mailing Address - Zip Code:33885-0565
Mailing Address - Country:US
Mailing Address - Phone:863-242-2287
Mailing Address - Fax:
Practice Address - Street 1:245 N SEMINOLE AVE
Practice Address - Street 2:
Practice Address - City:LAKE ALFRED
Practice Address - State:FL
Practice Address - Zip Code:33850-2119
Practice Address - Country:US
Practice Address - Phone:863-242-2287
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-18
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPO 2109213EP1101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213EP1101XPodiatric Medicine & Surgery Service ProvidersPodiatristPrimary Podiatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLBH9544099OtherDEA REGISTRATION
FLU18574Medicare UPIN
FLBH9544099OtherDEA REGISTRATION