Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207R00000X | Internist | 2017029653 | MO |
Y | 111NI0900X | Internist | 2017029653 | MO |
N | 207R00000X | Internist | P9230 | TX |
N | 111NI0900X | Internist | P9230 | TX |
NPI | 1003104118 |
---|---|
Provider Name | Betty Carolyn Murray |
First Address | Joplin, MO 64804-2500 |
Second Address | Joplin, MO 64804-2500 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/07/2011 |
Last Update Date | 16/08/2017 |