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NPI Code Detail

MEDICARE: KEVIN L. MURPHY M.D.

MEDICARE: KEVIN L. MURPHY M.D.
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
12084P0805XGeriatric Psychiatry Physician01045482AIN

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
3330004393OTHERINRAILROAD MEDICARE
6P00466957OTHERINRAILROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
26942OTHERINPHYSICIANS HEALTH PLAN
4MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5000000543921OTHERINANTHEM

General Provider Information

NPI Number : 1053390765
Entity Type Code : Individual
Provider Name (Legal Business Name) : KEVIN L. MURPHY M.D.
Provider Business Mailing Address
First Line : 11109 PARKVIEW PLAZA DR # 117
Second Line :
City : FORT WAYNE
State : IN
Zip : 46845-1701
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1720 BEACON ST
Second Line :
City : FORT WAYNE
State : IN
Zip : 46805-4749
Country : US
Telephone Number : 260-373-8000
Fax Number : 260-373-8034
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/11/2006
Last Update Date : 10/10/2022

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Directions to “ KEVIN L. MURPHY M.D.” Practice Location

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