Healthcare Provider Details

I. General information

NPI: 1801564935
Provider Name (Legal Business Name): GABRIELLE MURPHEY OD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/02/2021
Last Update Date: 09/30/2024
Certification Date: 09/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1061 HARMON AVE BLDG 302
FORT STEWART GA
31314-5641
US

IV. Provider business mailing address

1061 HARMON AVE BLDG 302
FORT STEWART GA
31314-5641
US

V. Phone/Fax

Practice location:
  • Phone: 912-435-6633
  • Fax:
Mailing address:
  • Phone: 912-435-6633
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberTUV009397
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberOPT003562
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: