Healthcare Provider Details

I. General information

NPI: 1700083979
Provider Name (Legal Business Name): MICHELLE MURRAY, DPM, PSC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/29/2007
Last Update Date: 08/18/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1101 SAINT CHRISTOPHER DRIVE SUITE 355
ASHLAND KY
41101-7000
US

IV. Provider business mailing address

1101 SAINT CHRISTOPHER DRIVE SUITE 355
ASHLAND KY
41101-7000
US

V. Phone/Fax

Practice location:
  • Phone: 606-833-0338
  • Fax: 606-833-0339
Mailing address:
  • Phone: 606-833-0338
  • Fax: 606-833-0339

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code213ES0131X
TaxonomyFoot Surgery Podiatrist
License Number00311
License Number StateKY

VIII. Authorized Official

Name: DR. MICHELLE A MURRAY
Title or Position: PHYSICIAN/OWNDER
Credential: DPM
Phone: 606-833-0338