Provider Demographics
NPI:1194748327
Name:MURPHY, TIMOTHY G (DO)
Entity type:Individual
Prefix:DR
First Name:TIMOTHY
Middle Name:G
Last Name:MURPHY
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 15109
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28408-5109
Mailing Address - Country:US
Mailing Address - Phone:910-392-2525
Mailing Address - Fax:910-392-2827
Practice Address - Street 1:1709 S 16TH ST
Practice Address - Street 2:STE A
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28401-6429
Practice Address - Country:US
Practice Address - Phone:910-452-8633
Practice Address - Fax:910-452-8569
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2023-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY256371207Q00000X, 207P00000X
NC200000910207Q00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC127GWOtherBLUE CROSS & BLUE SHIELD
NC89127GWMedicaid
NC127GWOtherBLUE CROSS & BLUE SHIELD
NC2401151FMedicare PIN
NCH25147Medicare UPIN