Healthcare Provider Details

I. General information

NPI: 1134109572
Provider Name (Legal Business Name): WILLIAM D MURRELL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/20/2006
Last Update Date: 10/09/2023
Certification Date: 10/09/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

815 COURT ST STE 4
JACKSON CA
95642-2154
US

IV. Provider business mailing address

815 COURT ST STE 4
JACKSON CA
95642-2154
US

V. Phone/Fax

Practice location:
  • Phone: 209-217-8416
  • Fax:
Mailing address:
  • Phone: 518-561-2000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number227907
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberCDRH.0066414
License Number StateCO
# 3
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberME155808
License Number StateFL
# 4
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number5161
License Number StateSD
# 5
Primary TaxonomyN
Taxonomy Code207XX0005X
TaxonomySports Medicine (Orthopaedic Surgery) Physician
License NumberCDRH.0066414
License Number StateCO
# 6
Primary TaxonomyY
Taxonomy Code207XX0005X
TaxonomySports Medicine (Orthopaedic Surgery) Physician
License NumberA84674
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: