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NPI Code Detail

MEDICARE: KEVIN R MURPHY D.D.S.

MEDICARE: KEVIN R MURPHY D.D.S.
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
11223G0001XGeneral Practice Dentistry18472MI

General Provider Information

NPI Number : 1093848467
Entity Type Code : Organization
Provider Name (Legal Business Name) : KEVIN R MURPHY D.D.S.
Provider Business Mailing Address
First Line : 4124 W ST JOE HWY
Second Line :
City : LANSING
State : MI
Zip : 48917-5205
Country : US
Telephone Number : 517-321-4815
Fax Number : 517-321-8171
Provider Business Practice Location Address
First Line : 4124 W ST JOE HWY
Second Line :
City : LANSING
State : MI
Zip : 48917-5205
Country : US
Telephone Number : 517-321-4815
Fax Number : 517-321-8171
Authorized Official
Title or Position : VICE PRESIDENT
Name : DR. KEVIN R MURPHY
Credential : D.D.S.
Telephone Number : 517-321-4815
Provider Enumeration Date : 03/14/2007
Last Update Date : 08/22/2020

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