Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 122300000X | Dentist | 6468 | KY |
Y | 1223S0112X | Oral and Maxillofacial Surgeon | 6468 | KY |
N | 204E00000X | Oral & Maxillofacial Surgeon | 6468 | KY |
NPI | 1093827610 |
---|---|
Provider Name | Dr. Michael Timothy Murphy |
First Address | Corbin, KY 40701-2739 |
Second Address | Corbin, KY 40701-2739 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/08/2006 |
Last Update Date | 25/06/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
60064680 | (05) | KY |
64064686 | (05) | KY |
U63150 | (02) |