Provider Demographics
NPI:1588917884
Name:MURPHY, JAMISON WILLIAM (IDC)
Entity type:Individual
Prefix:MR
First Name:JAMISON
Middle Name:WILLIAM
Last Name:MURPHY
Suffix:
Gender:M
Credentials:IDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:204 TULIP LN
Mailing Address - Street 2:
Mailing Address - City:OCEANSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92058-8658
Mailing Address - Country:US
Mailing Address - Phone:562-279-4081
Mailing Address - Fax:
Practice Address - Street 1:USS HOWARD DDG 83
Practice Address - Street 2:
Practice Address - City:FPO
Practice Address - State:AP
Practice Address - Zip Code:92220
Practice Address - Country:US
Practice Address - Phone:6195-554-4444
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-10-24
Last Update Date:2012-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1710I1002XOther Service ProvidersMilitary Health Care ProviderIndependent Duty Corpsman