Provider Demographics
NPI:1316066475
Name:MURPHREE, THOMAS BEATTY JR (DDS)
Entity type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:BEATTY
Last Name:MURPHREE
Suffix:JR
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 AUDERER BLVD
Mailing Address - Street 2:
Mailing Address - City:WAVELAND
Mailing Address - State:MS
Mailing Address - Zip Code:39576-2432
Mailing Address - Country:US
Mailing Address - Phone:228-270-0044
Mailing Address - Fax:228-270-0047
Practice Address - Street 1:110 AUDERER BLVD
Practice Address - Street 2:
Practice Address - City:WAVELAND
Practice Address - State:MS
Practice Address - Zip Code:39576-2432
Practice Address - Country:US
Practice Address - Phone:228-270-0044
Practice Address - Fax:228-270-0047
Is Sole Proprietor?:No
Enumeration Date:2007-03-28
Last Update Date:2018-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS1464-71122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS00660452Medicaid