=====================================================
General NPI Number Information
=====================================================
NPI Number | 1720082241
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | PAUL W. MURPHY M.D.
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/13/2005
-----------------------------------------------------
Last Update Date | 04/04/2013
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 9415 EAST HARRY BUILDING 800
-----------------------------------------------------
City | WICHITA
-----------------------------------------------------
State | KS
-----------------------------------------------------
Zip | 67207-5072
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 316-686-6303
-----------------------------------------------------
Fax | 316-686-6764
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 9415 E HARRY ST BLDG 800
-----------------------------------------------------
City | WICHITA
-----------------------------------------------------
State | KS
-----------------------------------------------------
Zip | 67207-5089
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 316-686-6303
-----------------------------------------------------
Fax | 316-686-6764
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 2084P0800X
-----------------------------------------------------
Taxonomy Name | Psychiatry Physician
-----------------------------------------------------
License Number | 04-20171
-----------------------------------------------------
License Number State | KS
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 2084P0800X
-----------------------------------------------------
Taxonomy Name | Psychiatry Physician
-----------------------------------------------------
License Number | 21317
-----------------------------------------------------
License Number State | NE
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 2084P0800X
-----------------------------------------------------
Taxonomy Name | Psychiatry Physician
-----------------------------------------------------
License Number | 24188
-----------------------------------------------------
License Number State | OK
-----------------------------------------------------