Provider Demographics
NPI:1306931712
Name:MURPHY, TERRY G (MD MS FACEP)
Entity type:Individual
Prefix:
First Name:TERRY
Middle Name:G
Last Name:MURPHY
Suffix:
Gender:F
Credentials:MD MS FACEP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:723 MEMORIAL STREET
Mailing Address - Street 2:
Mailing Address - City:PROSSER
Mailing Address - State:WA
Mailing Address - Zip Code:99350-1524
Mailing Address - Country:US
Mailing Address - Phone:509-786-2222
Mailing Address - Fax:509-786-6612
Practice Address - Street 1:723 MEMORIAL STREET
Practice Address - Street 2:
Practice Address - City:PROSSER
Practice Address - State:WA
Practice Address - Zip Code:99350-1524
Practice Address - Country:US
Practice Address - Phone:509-786-2222
Practice Address - Fax:509-786-6612
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-03
Last Update Date:2015-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA67144207PE0004X
WAMD00047439207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No207PE0004XAllopathic & Osteopathic PhysiciansEmergency MedicineEmergency Medical Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
605960011OtherUSDLAB FBL DEEOIC
CAA67144OtherCA LICENSE #
WA1650MUOtherBSWA
WA8476996Medicaid
WA0219168OtherLIWA
P00392810Medicare PIN
WA1650MUOtherBSWA
WA8476996Medicaid