Provider Demographics
NPI:1326001009
Name:MURPHY, KEVIN J (MD)
Entity type:Individual
Prefix:DR
First Name:KEVIN
Middle Name:J
Last Name:MURPHY
Suffix:
Gender:
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 7412031
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60674-2031
Mailing Address - Country:US
Mailing Address - Phone:314-837-0405
Mailing Address - Fax:314-395-7289
Practice Address - Street 1:1224 GRAHAM RD
Practice Address - Street 2:STE 1103
Practice Address - City:FLORISSANT
Practice Address - State:MO
Practice Address - Zip Code:63031-8028
Practice Address - Country:US
Practice Address - Phone:314-837-0405
Practice Address - Fax:314-395-7289
Is Sole Proprietor?:No
Enumeration Date:2006-04-11
Last Update Date:2025-04-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MOR8C51208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO200003479Medicaid