Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2082S0105X | Plastic Hand Surgeon | 0361086341 | IL |
N | 2086S0122X | Plastic and Reconstructive Surgery | 0361086341 | IL |
Y | 2086S0122X | Plastic and Reconstructive Surgery | ME 107954 | FL |
NPI | 1104869510 |
---|---|
Provider Name | John Murray |
First Address | Jacksonville, FL 32231-4008 |
Second Address | Jacksonville, FL 32207-4966 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/06/2006 |
Last Update Date | 04/02/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
003130076A | (05) | GA |
007624400 | (05) | FL |
0361086341 | (05) | IL |
149S8 | BCBSFL (01) | FL |
7215166 | BCBS (01) | IL |
H56475 | (02) | IL |