Provider Demographics
NPI:1346241767
Name:MURRAY, JILL A (MD)
Entity type:Individual
Prefix:
First Name:JILL
Middle Name:A
Last Name:MURRAY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1015 E PIKES PEAK AVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80903-3782
Mailing Address - Country:US
Mailing Address - Phone:719-473-2424
Mailing Address - Fax:719-227-1475
Practice Address - Street 1:1015 E PIKES PEAK AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80903-3782
Practice Address - Country:US
Practice Address - Phone:719-473-2424
Practice Address - Fax:719-227-1475
Is Sole Proprietor?:No
Enumeration Date:2005-08-09
Last Update Date:2014-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO35461207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO01354612Medicaid
CO01354612Medicaid
COCS5748Medicare ID - Type Unspecified