Provider Demographics
NPI:1912927922
Name:MURPHY, TIMOTHY (DC)
Entity Type:Individual
Prefix:
First Name:TIMOTHY
Middle Name:
Last Name:MURPHY
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1990 POPPS FERRY RD
Mailing Address - Street 2:
Mailing Address - City:BILOXI
Mailing Address - State:MS
Mailing Address - Zip Code:39532-2015
Mailing Address - Country:US
Mailing Address - Phone:228-374-6060
Mailing Address - Fax:228-374-5777
Practice Address - Street 1:1990 POPPS FERRY RD
Practice Address - Street 2:
Practice Address - City:BILOXI
Practice Address - State:MS
Practice Address - Zip Code:39532-2015
Practice Address - Country:US
Practice Address - Phone:228-374-6060
Practice Address - Fax:228-374-5777
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-20
Last Update Date:2012-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS0872111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS00115395Medicaid
MSU52242Medicare UPIN