Provider Demographics
NPI:1992739734
Name:MURPHY, R. SCOTT (DDS, MD)
Entity type:Individual
Prefix:DR
First Name:R.
Middle Name:SCOTT
Last Name:MURPHY
Suffix:
Gender:M
Credentials:DDS, MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2828 1ST AVE STE 104
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON
Mailing Address - State:WV
Mailing Address - Zip Code:25702-1244
Mailing Address - Country:US
Mailing Address - Phone:304-522-3200
Mailing Address - Fax:304-522-3401
Practice Address - Street 1:2828 1ST AVE STE 104
Practice Address - Street 2:
Practice Address - City:HUNTINGTON
Practice Address - State:WV
Practice Address - Zip Code:25702-1244
Practice Address - Country:US
Practice Address - Phone:304-522-3200
Practice Address - Fax:304-522-3401
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-10
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV32841223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2301931Medicaid
WV4003041000Medicaid
WV4003041000Medicaid
WVR9332581Medicare ID - Type Unspecified