Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207SG0201X | Clinical Genetics (M.D.) | 24438 | IA |
Y | 2080N0001X | Neonatal-Perinatal Doctor | 22438 | IA |
NPI | 1407842453 |
---|---|
Provider Name | Jeffrey C Murray |
First Address | Iowa City, IA 52242-1009 |
Second Address | Iowa City, IA 52242-1009 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/09/2005 |
Last Update Date | 28/09/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0218081 | (05) | IA |
21808 | WELLMARK BCBS (01) | IA |
A14494 | (02) |