Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213E00000X | Podiatrist | 153 | AL |
Y | 222Z00000X | Podiatrist | 153 | AL |
NPI | 1043386881 |
---|---|
Provider Name | Angela W Murphy |
First Address | Fort Payne, AL 35968-1613 |
Second Address | Fort Payne, AL 35968-3691 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/11/2006 |
Last Update Date | 26/05/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
51509634 | BCBS (01) | AL |
U55995 | (02) |