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General NPI Number Information
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NPI Number | 1407302888
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Entity Type | Individual
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Provider Name | TYSON COLTER MURRAY M.M.S.
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Gender | Male
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Dates
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Enumeration Date | 08/26/2016
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Last Update Date | 04/29/2025
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Provider Practice Location Address
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Address Line | 22601 N 19TH AVE STE 112
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City | PHOENIX
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State | AZ
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Zip | 85027-1324
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Country | US
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Telephone | 602-293-3277
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Fax | 602-283-4518
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Provider Business Mailing Address
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Address Line | 22601 N 19TH AVE STE 112
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City | PHOENIX
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State | AZ
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Zip | 85027-1324
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Country | US
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Telephone | 602-293-3277
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Fax | 602-283-4518
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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 | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 6558
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License Number State | AZ
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