MEDICARE: DR. CABOT STRATFORD MURDOCK 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	208600000X	Surgery Physician	7106789-1205	UT

General Provider Information

NPI Number	:	1225024961
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CABOT STRATFORD MURDOCK M.D

Provider Business Mailing Address
First Line	:	PO BOX 27128
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84127-0128
Country	:	US
Telephone Number	:	801-404-8634
Fax Number	:

Provider Business Practice Location Address
First Line	:	3723 W 12600 S
Second Line	:	SUITE 270
City	:	RIVERTON
State	:	UT
Zip	:	84065-7295
Country	:	US
Telephone Number	:	801-285-4620
Fax Number	:

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

Provider Enumeration Date	:	09/27/2005
Last Update Date	:	09/17/2012

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