Provider Demographics
NPI:1881317758
Name:MURPHY, ERIC JOHNDELL (MS, MABC)
Entity type:Individual
Prefix:
First Name:ERIC
Middle Name:JOHNDELL
Last Name:MURPHY
Suffix:
Gender:M
Credentials:MS, MABC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:317 PEACHWOOD CIR
Mailing Address - Street 2:
Mailing Address - City:HAUGHTON
Mailing Address - State:LA
Mailing Address - Zip Code:71037-7718
Mailing Address - Country:US
Mailing Address - Phone:318-393-7892
Mailing Address - Fax:
Practice Address - Street 1:317 PEACHWOOD CIR
Practice Address - Street 2:
Practice Address - City:HAUGHTON
Practice Address - State:LA
Practice Address - Zip Code:71037-7718
Practice Address - Country:US
Practice Address - Phone:318-393-7892
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-26
Last Update Date:2022-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator