Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213E00000X | Podiatrist | 016004652 | IL |
Y | 222Z00000X | Podiatrist | 016004652 | IL |
N | 2081S0010X | Sports Medicine | 016004652 | IL |
N | 213ES0000X | Sports Medicine | 016004652 | IL |
N | 213ES0131X | Foot Surgery | 016004652 | IL |
NPI | 1174590178 |
---|---|
Provider Name | Dr. Stephen C. Murphy |
First Address | Portage, WI 53901-0387 |
Second Address | Portage, WI 53901-0387 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/03/2006 |
Last Update Date | 31/01/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
016004652 | (05) | IL |
01622732 | BLUE CROSS (01) | |
480025958 | RR MCR (01) | |
U33912 | (02) | IL |