Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QG0300X | Family Doctor - Geriatric Medicine | MD06116 | RI |
NPI | 1336189406 |
---|---|
Provider Name | John B Murphy |
First Address | Providence, RI 02901-1358 |
Second Address | Pawtucket, RI 02860-5299 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/06/2006 |
Last Update Date | 15/11/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
9006030 | (05) | RI |