Healthcare Provider Details

I. General information

NPI: 1437214145
Provider Name (Legal Business Name): MURRAY PEDIATRICS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/22/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 S 8TH ST SUITE 208E
MURRAY KY
42071-2400
US

IV. Provider business mailing address

300 S 8TH ST SUITE 208E
MURRAY KY
42071-2400
US

V. Phone/Fax

Practice location:
  • Phone: 270-759-9223
  • Fax: 270-753-7345
Mailing address:
  • Phone: 270-759-9223
  • Fax: 270-753-7345

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: MRS. MICHELLE GIPSON
Title or Position: CREDINTIALING SPECIALIST
Credential:
Phone: 270-759-9223