MEDICARE: MR. BRIAN ALAN MURPHY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	247200000X	Other Technician

General Provider Information

NPI Number	:	1417010901
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. BRIAN ALAN MURPHY

Provider Business Mailing Address
First Line	:	1530 FERNWOOD DR
Second Line	:
City	:	SLIDELL
State	:	LA
Zip	:	70458-3120
Country	:	US
Telephone Number	:	904-472-0832
Fax Number	:	504-253-6532

Provider Business Practice Location Address
First Line	:	13800 OLD GENTILLY RD
Second Line	:	USCG MEDICAL
City	:	NEW ORLEANS
State	:	LA
Zip	:	70129-2218
Country	:	US
Telephone Number	:	504-253-6515
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/18/2006
Last Update Date	:	07/08/2007

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