Healthcare Provider Details

I. General information

NPI: 1366674699
Provider Name (Legal Business Name): COLLEEN M. MURPHY, MD, FACOG, CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/20/2009
Last Update Date: 11/18/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4100 LAKE OTIS PKWY STE 330
ANCHORAGE AK
99508-5232
US

IV. Provider business mailing address

4100 LAKE OTIS PKWY STE 330
ANCHORAGE AK
99508-5232
US

V. Phone/Fax

Practice location:
  • Phone: 907-770-5432
  • Fax: 907-770-5431
Mailing address:
  • Phone: 907-770-5432
  • Fax: 907-770-5431

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License Number3162
License Number StateAK

VIII. Authorized Official

Name: DR. COLLEEN M MURPHY
Title or Position: MEDICAL DIRECTOR
Credential: MD
Phone: 907-770-5432