Provider Demographics
NPI:1194775213
Name:MURPHY, BENTON F (MD)
Entity type:Individual
Prefix:DR
First Name:BENTON
Middle Name:F
Last Name:MURPHY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27 MONTEBELLO RD
Mailing Address - Street 2:
Mailing Address - City:PUEBLO
Mailing Address - State:CO
Mailing Address - Zip Code:81001-1236
Mailing Address - Country:US
Mailing Address - Phone:719-545-1530
Mailing Address - Fax:719-545-2899
Practice Address - Street 1:27 MONTEBELLO RD
Practice Address - Street 2:
Practice Address - City:PUEBLO
Practice Address - State:CO
Practice Address - Zip Code:81001-1236
Practice Address - Country:US
Practice Address - Phone:719-545-1530
Practice Address - Fax:719-545-2899
Is Sole Proprietor?:No
Enumeration Date:2006-05-11
Last Update Date:2014-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO21789207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
COCO1789OtherEYEMED EYECARE
CO01217892Medicaid
CO0452890001OtherMEDICARE DMERC
CO608439600OtherUS DEPT OF LABOR WORK COM
COK2048OtherFEDERAL BCBS
COK2048OtherANTHEM BCBS
CO180015898OtherRAILROAD MEDICARE
CO608439600OtherUS DEPT OF LABOR WORK COM
COA16129Medicare UPIN
CO180015898OtherRAILROAD MEDICARE