Provider Demographics
NPI:1831212315
Name:MURRELL, JOHN MILTON (DPM)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:MILTON
Last Name:MURRELL
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 30306
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31410-0306
Mailing Address - Country:US
Mailing Address - Phone:912-233-5316
Mailing Address - Fax:912-233-3859
Practice Address - Street 1:908 ABERCORN ST
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31401-5912
Practice Address - Country:US
Practice Address - Phone:912-233-5316
Practice Address - Fax:912-233-3859
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-09
Last Update Date:2019-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA000566213EP1101X, 213ES0131X, 213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
No213EP1101XPodiatric Medicine & Surgery Service ProvidersPodiatristPrimary Podiatric Medicine
No213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000347696AMedicaid
GA582403662OtherOTHER PRIVATE INSURANCES
GA10057776Medicaid
GA629996OtherGHI INSURANCE
GA340261Medicaid
GA480026657Medicare PIN
GA582403662OtherOTHER PRIVATE INSURANCES
GA10057776Medicaid
GA340261Medicaid
GA48SCBJNMedicare PIN
GA000347696AMedicaid