Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223D0001X | Dental Public Health | 3863 | LA |
NPI | 1053415174 |
---|---|
Provider Name | Dr. Andrew G Murphy |
First Address | Mansfield, LA 71052 |
Second Address | Mansfield, LA 71052 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/09/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1838632 | (05) | LA |