MEDICARE: DR. DAVID EDWARD MUFFLY 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
1	174400000X	Specialist	22134	KY
2	207X00000X	Orthopaedic Surgery Physician	22134	KY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	000000048741	OTHER	KY	ANTHEM BC/BS
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1063416741
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DAVID EDWARD MUFFLY M.D.

Provider Business Mailing Address
First Line	:	425 BLACK DIAMOND RD
Second Line	:
City	:	CORBIN
State	:	KY
Zip	:	40701-9526
Country	:	US
Telephone Number	:	606-528-0600
Fax Number	:	606-528-7413

Provider Business Practice Location Address
First Line	:	1490 CUMBERLAND FALLS HWY
Second Line	:
City	:	CORBIN
State	:	KY
Zip	:	40701-2721
Country	:	US
Telephone Number	:	606-528-0600
Fax Number	:	606-528-7413

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

Provider Enumeration Date	:	06/09/2005
Last Update Date	:	02/03/2011

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