Provider Demographics
NPI:1891790598
Name:MURPHY, PATRICK JOHN (MD)
Entity type:Individual
Prefix:
First Name:PATRICK
Middle Name:JOHN
Last Name:MURPHY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4108 ZUCK RD
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16506-4539
Mailing Address - Country:US
Mailing Address - Phone:814-877-5333
Mailing Address - Fax:814-877-5329
Practice Address - Street 1:4108 ZUCK RD
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16506-4539
Practice Address - Country:US
Practice Address - Phone:814-877-5333
Practice Address - Fax:814-877-5329
Is Sole Proprietor?:No
Enumeration Date:2005-06-17
Last Update Date:2024-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD422184207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2416657OtherOH MEDICAL ASSISTANCE
PA3560963OtherAETNA
NY02433576OtherNY MEDICAL ASSISTANCE
PA1505402OtherBLUE SHIELD
PAP004646OtherGATEWAY
NY00026388301OtherUNIVERA
PA0019595670003Medicaid
PA323629OtherUPMC
PA226768OtherUNISON
PAP00049562OtherRR MEDICARE
OH2416657OtherOH MEDICAL ASSISTANCE
PA0019595670003Medicaid