MEDICARE: DR. MURKE FRANKLIN HARRISON DO LTD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	036076625	IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	04122575	OTHER	IL	BCBS

General Provider Information

NPI Number	:	1003807157
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MURKE FRANKLIN HARRISON DO LTD

Provider Business Mailing Address
First Line	:	PO BOX 767
Second Line	:
City	:	MOUNT VERNON
State	:	IL
Zip	:	62864-0015
Country	:	US
Telephone Number	:	618-244-2000
Fax Number	:	618-244-6625

Provider Business Practice Location Address
First Line	:	2712 BROADWAY ST
Second Line	:
City	:	MOUNT VERNON
State	:	IL
Zip	:	62864-2342
Country	:	US
Telephone Number	:	618-244-2000
Fax Number	:	618-244-6625

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/28/2005
Last Update Date	:	06/28/2016

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