Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | 20210 | KY |
Y | 207QG0300X | Family Doctor - Geriatric Medicine | 20210 | KY |
NPI | 1306897251 |
---|---|
Provider Name | Patrick J Murphy JR. |
First Address | Louisville, KY 40201-0909 |
Second Address | Louisville, KY 40208 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/05/2006 |
Last Update Date | 04/04/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
200244710 | (05) | IN |
64202104 | (05) | KY |