Provider Demographics
NPI:1801944525
Name:TOM MURRAY MD, INC
Entity type:Organization
Organization Name:TOM MURRAY MD, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ALICE
Authorized Official - Middle Name:H
Authorized Official - Last Name:MURRAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:740-732-7022
Mailing Address - Street 1:317 WEST ST
Mailing Address - Street 2:
Mailing Address - City:CALDWELL
Mailing Address - State:OH
Mailing Address - Zip Code:43724-1338
Mailing Address - Country:US
Mailing Address - Phone:740-732-7022
Mailing Address - Fax:
Practice Address - Street 1:317 WEST ST
Practice Address - Street 2:
Practice Address - City:CALDWELL
Practice Address - State:OH
Practice Address - Zip Code:43724-1338
Practice Address - Country:US
Practice Address - Phone:740-732-7022
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-08
Last Update Date:2008-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-07-8057M207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0105307OtherUNITED HEALTHCARE
OH7100213OtherAETNA
OH223669044006OtherMEDICAL MUTUAL
OHD78057OtherHEALTH PLAN
OHMURRAY,TOtherCARESOURCE
OH2204171Medicaid
OH000000330018OtherANTHEM
OH181405OtherUNISON
OHMURRAY,TOtherCARESOURCE
OH7100213OtherAETNA
OHPOO139745 GRPDB9643Medicare ID - Type UnspecifiedMADICARE RR
OHMU4034203Medicare ID - Type UnspecifiedMEDICARE