MEDICARE: MURPHY OPTOMETRY I, LP

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	152W00000X	Optometrist

General Provider Information

NPI Number	:	1811519333
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MURPHY OPTOMETRY I, LP

Provider Business Mailing Address
First Line	:	9051 WATSON RD STE D
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63126-2240
Country	:	US
Telephone Number	:	314-962-1700
Fax Number	:	314-962-3297

Provider Business Practice Location Address
First Line	:	9051 WATSON RD STE D
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63126-2240
Country	:	US
Telephone Number	:	314-962-1700
Fax Number	:	314-962-3297

Authorized Official
Title or Position	:	OWNER/DOCTOR
Name	:	MARY A MURPHY
Credential	:	OD
Telephone Number	:	314-962-1700

Provider Enumeration Date	:	05/07/2020
Last Update Date	:	05/07/2020

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