Healthcare Provider Details

I. General information

NPI: 1013918739
Provider Name (Legal Business Name): FRED Y MURPHY MD PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/03/2005
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1010 N DUDNEY RD STE C
MAGNOLIA AR
71753-2624
US

IV. Provider business mailing address

1010 N DUDNEY RD STE C
MAGNOLIA AR
71753-2624
US

V. Phone/Fax

Practice location:
  • Phone: 870-234-7101
  • Fax: 870-234-7717
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberC6451
License Number StateAR

VIII. Authorized Official

Name: DR. FRED Y MURPHY
Title or Position: PHYSICIAN
Credential: MD
Phone: 870-234-7101