Provider Demographics
NPI:1285807842
Name:DK MURPHY DC PC
Entity type:Organization
Organization Name:DK MURPHY DC PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:SHREVE
Authorized Official - Last Name:MURPHY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:563-324-5829
Mailing Address - Street 1:3534 JERSEY RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:DAVENPORT
Mailing Address - State:IA
Mailing Address - Zip Code:52807-2223
Mailing Address - Country:US
Mailing Address - Phone:563-324-5829
Mailing Address - Fax:563-324-5013
Practice Address - Street 1:3534 JERSEY RIDGE RD
Practice Address - Street 2:
Practice Address - City:DAVENPORT
Practice Address - State:IA
Practice Address - Zip Code:52807-2223
Practice Address - Country:US
Practice Address - Phone:563-324-5829
Practice Address - Fax:563-324-5013
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DK MURPHY DC PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-04-03
Last Update Date:2011-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA04599111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
T00946Medicare UPIN
15963Medicare PIN