Provider Demographics
NPI:1972798080
Name:MURPHY, PATRICK JAMES (MD)
Entity type:Individual
Prefix:
First Name:PATRICK
Middle Name:JAMES
Last Name:MURPHY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1425 N 6TH ST
Mailing Address - Street 2:
Mailing Address - City:SHEBOYGAN
Mailing Address - State:WI
Mailing Address - Zip Code:53081-3519
Mailing Address - Country:US
Mailing Address - Phone:920-458-1574
Mailing Address - Fax:
Practice Address - Street 1:1730 W SNELL RD
Practice Address - Street 2:
Practice Address - City:OSHKOSH
Practice Address - State:WI
Practice Address - Zip Code:54901-1140
Practice Address - Country:US
Practice Address - Phone:920-231-4010
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-09-11
Last Update Date:2007-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI28564207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WIB55269Medicare UPIN