Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NS0005X | Chiropractic Sports Physician | 2323 | OH |
N | 363LF0000X | Nurse Practitioner - Family Medicine | APRN.CNP.026507 | OH |
NPI | 1326031295 |
---|---|
Provider Name | James Mattson Murdock |
First Address | Fairfield Township, OH 45011-0548 |
Second Address | Fairfield Township, OH 45011-0548 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/08/2005 |
Last Update Date | 26/01/2021 |