Provider Demographics
NPI:1982903597
Name:DR WINSTON MURRAY APMC
Entity Type:Organization
Organization Name:DR WINSTON MURRAY APMC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:WINSTON
Authorized Official - Middle Name:LLOYD
Authorized Official - Last Name:MURRAY
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:985-542-5800
Mailing Address - Street 1:109 W MINNESOTA PARK RD STE 3
Mailing Address - Street 2:
Mailing Address - City:HAMMOND
Mailing Address - State:LA
Mailing Address - Zip Code:70403-6130
Mailing Address - Country:US
Mailing Address - Phone:985-542-5800
Mailing Address - Fax:985-542-0134
Practice Address - Street 1:109 W MINNESOTA PARK RD STE 3
Practice Address - Street 2:
Practice Address - City:HAMMOND
Practice Address - State:LA
Practice Address - Zip Code:70403-6130
Practice Address - Country:US
Practice Address - Phone:985-542-5800
Practice Address - Fax:985-542-0134
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-22
Last Update Date:2011-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA05020R207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1301477Medicaid
LAB65590Medicare UPIN