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General NPI Number Information
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NPI Number | 1902841604
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Entity Type | Individual
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Provider Name | MURRAY S. WILLOCK M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/17/2006
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Last Update Date | 02/09/2015
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Provider Practice Location Address
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Address Line | 2605 JACKSON AVE
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City | POINT PLEASANT
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State | WV
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Zip | 25550-1615
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Country | US
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Telephone | 304-675-4498
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Fax | 304-675-8182
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Provider Business Mailing Address
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Address Line | 90 JACKSON PIKE
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City | GALLIPOLIS
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State | OH
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Zip | 45631-1560
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Country | US
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Telephone | 304-675-4498
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Fax | 304-675-2103
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 35-03-1929
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 15281
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License Number State | WV
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