Healthcare Provider Details

I. General information

NPI: 1265499891
Provider Name (Legal Business Name): RICHARD D MURRAY M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/27/2006
Last Update Date: 04/19/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15641 NEW HAMPSHIRE CT
FT MYERS FL
33908-4123
US

IV. Provider business mailing address

15641 NEW HAMPSHIRE CT
FT MYERS FL
33908-4123
US

V. Phone/Fax

Practice location:
  • Phone: 239-275-4300
  • Fax: 239-275-1870
Mailing address:
  • Phone: 239-275-4300
  • Fax: 239-275-1870

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberME0070890
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License NumberME0070890
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: