Healthcare Provider Details

I. General information

NPI: 1841293115
Provider Name (Legal Business Name): KRISHNA MURTHY M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/31/2005
Last Update Date: 09/29/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

685 VAIL ST
PRINCETON IN
47670-9510
US

IV. Provider business mailing address

PO BOX 1510
EVANSVILLE IN
47706-1510
US

V. Phone/Fax

Practice location:
  • Phone: 812-386-6560
  • Fax: 812-386-6698
Mailing address:
  • Phone: 812-386-6560
  • Fax: 812-385-5015

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number01031888A
License Number StateIN
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number01031888A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: