Healthcare Provider Details

I. General information

NPI: 1376779793
Provider Name (Legal Business Name): DONALD R MURPHY JR. PAC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/01/2009
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1824 HILLANDALE RD VAMC
DURHAM NC
27705
US

IV. Provider business mailing address

1824 HILLANDALE ROAD VAMC
DURHAM NC
27705
US

V. Phone/Fax

Practice location:
  • Phone: 919-383-6107
  • Fax: 919-383-6128
Mailing address:
  • Phone: 919-383-6107
  • Fax: 919-383-6128

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number664
License Number StateWV
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number0010-06961
License Number StateNC

VII. Legacy identifiers

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: