Provider Demographics
NPI:1952549065
Name:TIMOTHY F. MURPHY, M.D.,P.C.
Entity Type:Organization
Organization Name:TIMOTHY F. MURPHY, M.D.,P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:F
Authorized Official - Last Name:MURPHY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:231-843-6767
Mailing Address - Street 1:913 E LUDINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:LUDINGTON
Mailing Address - State:MI
Mailing Address - Zip Code:49431-2437
Mailing Address - Country:US
Mailing Address - Phone:231-425-4747
Mailing Address - Fax:231-425-4744
Practice Address - Street 1:913 E LUDINGTON AVE
Practice Address - Street 2:
Practice Address - City:LUDINGTON
Practice Address - State:MI
Practice Address - Zip Code:49431-2437
Practice Address - Country:US
Practice Address - Phone:231-425-4747
Practice Address - Fax:231-425-4744
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-27
Last Update Date:2010-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301052832174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI104483961Medicaid
MI104483961Medicaid
MI0N65070Medicare PIN