Provider Demographics
NPI:1194755447
Name:MURPHY, DAVID P (DPM)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:P
Last Name:MURPHY
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 W ONEIDA ST
Mailing Address - Street 2:
Mailing Address - City:WAYCROSS
Mailing Address - State:GA
Mailing Address - Zip Code:31501-5337
Mailing Address - Country:US
Mailing Address - Phone:912-283-6471
Mailing Address - Fax:912-283-1618
Practice Address - Street 1:2003 ALICE ST
Practice Address - Street 2:
Practice Address - City:WAYCROSS
Practice Address - State:GA
Practice Address - Zip Code:31501-6209
Practice Address - Country:US
Practice Address - Phone:912-283-6471
Practice Address - Fax:912-283-2598
Is Sole Proprietor?:No
Enumeration Date:2006-07-03
Last Update Date:2009-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPOD000851213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000785133AMedicaid
571257OtherBLUE SHIELD
P00099862OtherRAILROAD MEDICARE
P00099862OtherRAILROAD MEDICARE
GA48SCCNVMedicare PIN
GAU69793Medicare UPIN