Healthcare Provider Details

I. General information

NPI: 1790776987
Provider Name (Legal Business Name): TIMOTHY P MURPHY MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/04/2005
Last Update Date: 06/17/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20 CATAMORE BLVD RHODE ISLAND MEDICAL IMAGING
EAST PROVIDENCE RI
02914-1204
US

IV. Provider business mailing address

20 CATAMORE BLVD
EAST PROVIDENCE RI
02914-1204
US

V. Phone/Fax

Practice location:
  • Phone: 401-432-2520
  • Fax: 401-432-2457
Mailing address:
  • Phone: 401-432-2520
  • Fax: 401-432-2457

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number7773
License Number StateRI
# 2
Primary TaxonomyY
Taxonomy Code2085R0204X
TaxonomyVascular & Interventional Radiology Physician
License Number07773
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: