Healthcare Provider Details

I. General information

NPI: 1912945759
Provider Name (Legal Business Name): TAMELA MARIE BROWN-MURRAY O.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/03/2006
Last Update Date: 06/06/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

165 PARKER'S MILL WAY
SOMERSET KY
42503
US

IV. Provider business mailing address

165 PARKERS MILL WAY
SOMERSET KY
42503-4151
US

V. Phone/Fax

Practice location:
  • Phone: 606-677-0377
  • Fax: 606-677-6542
Mailing address:
  • Phone: 606-677-0377
  • Fax: 606-677-6542

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number1544DT
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: