Provider Demographics
NPI:1124124318
Name:MURPHY, TAMARA J (PA)
Entity type:Individual
Prefix:MRS
First Name:TAMARA
Middle Name:J
Last Name:MURPHY
Suffix:
Gender:F
Credentials:PA
Other - Prefix:MISS
Other - First Name:TAMARA
Other - Middle Name:JALEEN
Other - Last Name:ORR
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PA-C
Mailing Address - Street 1:717 STATE STREET, SUITE 16LL
Mailing Address - Street 2:REGIONAL HEALTH SERVICES, INC.
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16501-1360
Mailing Address - Country:US
Mailing Address - Phone:814-877-7100
Mailing Address - Fax:814-877-2939
Practice Address - Street 1:100 PEACH STREET, SUITE 200
Practice Address - Street 2:BAYFRONT DIGESTIVE DISEASE
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16507-1423
Practice Address - Country:US
Practice Address - Phone:814-456-7733
Practice Address - Fax:814-456-7213
Is Sole Proprietor?:No
Enumeration Date:2006-09-15
Last Update Date:2011-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA052657363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
P00438710OtherRAILROAD MEDICARE
1921578OtherBLUE SHIELD
106017FTGMedicare PIN