Healthcare Provider Details

I. General information

NPI: 1659472637
Provider Name (Legal Business Name): CRAIG P MURTHA O.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/25/2006
Last Update Date: 01/10/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2368 CHERRY RD
ROCK HILL SC
29732-2165
US

IV. Provider business mailing address

2368 CHERRY RD
ROCK HILL SC
29732-2165
US

V. Phone/Fax

Practice location:
  • Phone: 803-366-6111
  • Fax: 803-366-6544
Mailing address:
  • Phone: 803-366-6111
  • Fax: 803-366-6544

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number781
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: