Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207QA0401X | Family Doctor - Addiction Medicine | 0101058597 | VA |
Y | 207QA0401X | Family Doctor - Addiction Medicine | 35-07-8057M | OH |
N | 207QA0401X | Family Doctor - Addiction Medicine | 9700681 | NC |
N | 207QA0401X | Family Doctor - Addiction Medicine | ME37864 | FL |
NPI | 1679569107 |
---|---|
Provider Name | Dr. Thomas Douglas Murray |
First Address | Caldwell, OH 43724-1338 |
Second Address | Caldwell, OH 43724-1338 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/09/2005 |
Last Update Date | 22/04/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000000330018 | ANTHEM (01) | OH |
0105307 | UNITED HEALTH CARE (01) | OH |
200868933 | CIGNA (01) | OH |
2204171 | (05) | OH |
7100213 | AETNA (01) | OH |
D78057 | THE HEALTH PLAN (01) | OH |
D86505 | (02) | OH |