Healthcare Provider Details

I. General information

NPI: 1174627657
Provider Name (Legal Business Name): JOHN E. MURPHY, III
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/12/2006
Last Update Date: 08/12/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6438 WILMINGTON PIKE SUITE110
CENTERVILLE OH
45459-7010
US

IV. Provider business mailing address

6438 WILMINGTON PIKE SUITE110
CENTERVILLE OH
45459-7010
US

V. Phone/Fax

Practice location:
  • Phone: 937-848-4121
  • Fax: 937-848-5965
Mailing address:
  • Phone: 937-848-4121
  • Fax: 937-848-5965

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. JOHN MURPHY III
Title or Position: PHYSICIAN
Credential: D.O.
Phone: 937-848-4121