Provider Demographics
NPI:1780388223
Name:WAIR, MURPHY JR
Entity type:Individual
Prefix:MR
First Name:MURPHY
Middle Name:
Last Name:WAIR
Suffix:JR
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 1:2911 WILLOW CREEK ESTATES DR
Mailing Address - Street 2:
Mailing Address - City:FLORISSANT
Mailing Address - State:MO
Mailing Address - Zip Code:63031-1661
Mailing Address - Country:US
Mailing Address - Phone:314-518-0848
Mailing Address - Fax:
Practice Address - Street 1:2911 WILLOW CREEK ESTATES DR
Practice Address - Street 2:
Practice Address - City:FLORISSANT
Practice Address - State:MO
Practice Address - Zip Code:63031-1661
Practice Address - Country:US
Practice Address - Phone:314-518-0848
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-29
Last Update Date:2023-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ILW600-5406-7257172A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172A00000XOther Service ProvidersDriver