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General NPI Number Information
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NPI Number | 1952553927
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Entity Type | Organization
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Legal Business Name | MURRAY PEDIATRICS
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Dates
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Enumeration Date | 10/21/2008
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Last Update Date | 01/11/2013
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Provider Practice Location Address
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Address Line | 300 S 8TH ST STE 208E
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City | MURRAY
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State | KY
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Zip | 42071-2472
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Country | US
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Telephone | 270-759-9223
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Fax |
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Provider Business Mailing Address
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Address Line | 300 S 8TH ST STE 208E
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City | MURRAY
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State | KY
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Zip | 42071-2472
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Country | US
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Telephone | 270-759-9223
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. CLEGG F AUSTIN
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Credential | M.D.
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Telephone | 270-759-9223
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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