Healthcare Provider Details

I. General information

NPI: 1306587589
Provider Name (Legal Business Name): JOHN MURRAY MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/05/2022
Last Update Date: 10/07/2026
Certification Date: 10/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5001 HARDY ST
HATTIESBURG MS
39402-1308
US

IV. Provider business mailing address

504 MARENGO AVE
FOREST PARK IL
60130-1915
US

V. Phone/Fax

Practice location:
  • Phone: 601-296-3963
  • Fax:
Mailing address:
  • Phone: 708-427-1961
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number92619
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: