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General NPI Number Information
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NPI Number | 1093813875
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Entity Type | Individual
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Provider Name | KEVIN D MURRAY M.D.
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Gender | Male
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Dates
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Enumeration Date | 09/20/2006
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Last Update Date | 10/19/2012
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Provider Practice Location Address
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Address Line | 1125 S MADISON ST
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City | JEFFERSON CITY
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State | MO
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Zip | 65101-0000
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Country | US
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Telephone | 573-634-7141
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Fax | 573-632-5962
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Provider Business Mailing Address
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Address Line | PO BOX 7687
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City | COLUMBIA
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State | MO
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Zip | 65205-7687
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Country | US
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Telephone | 573-882-2259
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208G00000X
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Taxonomy Name | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
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License Number | 99022637
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 208G00000X
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Taxonomy Name | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
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License Number | 12297
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License Number State | HI
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Taxonomy #3
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Taxonomy Code | 208G00000X
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Taxonomy Name | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
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License Number | 2009018473
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License Number State | MO
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