Provider Demographics
NPI:1801966775
Name:MURRAY, HARRY M III (OD)
Entity type:Individual
Prefix:DR
First Name:HARRY
Middle Name:M
Last Name:MURRAY
Suffix:III
Gender:M
Credentials:OD
Other - Prefix:DR
Other - First Name:HARRY
Other - Middle Name:M
Other - Last Name:MURRAY
Other - Suffix:III
Other - Last Name Type:Other Name
Other - Credentials:ODO
Mailing Address - Street 1:107 DOCTORS DR
Mailing Address - Street 2:
Mailing Address - City:BRIDGEPORT
Mailing Address - State:WV
Mailing Address - Zip Code:26330-1720
Mailing Address - Country:US
Mailing Address - Phone:304-842-6226
Mailing Address - Fax:304-842-6253
Practice Address - Street 1:107 DOCTORS DR
Practice Address - Street 2:
Practice Address - City:BRIDGEPORT
Practice Address - State:WV
Practice Address - Zip Code:26330-1720
Practice Address - Country:US
Practice Address - Phone:304-842-6226
Practice Address - Fax:304-842-6253
Is Sole Proprietor?:No
Enumeration Date:2006-11-08
Last Update Date:2010-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV700OD152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WVT32429Medicare UPIN
MU0598482Medicare PIN