MEDICARE: JAMES MURPHY DMD OMS

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	1223S0112X	Oral and Maxillofacial Surgery (Dentist)	042767-1	NY

General Provider Information

NPI Number	:	1316070436
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAMES MURPHY DMD OMS

Provider Business Mailing Address
First Line	:	PO BOX 3189
Second Line	:
City	:	SYRACUSE
State	:	NY
Zip	:	13220-3189
Country	:	US
Telephone Number	:	315-454-6000
Fax Number	:	315-454-8650

Provider Business Practice Location Address
First Line	:	124 NORTHERN LIGHTS DR
Second Line	:
City	:	N SYRACUSE
State	:	NY
Zip	:	13212-4108
Country	:	US
Telephone Number	:	315-455-2411
Fax Number	:	315-455-1899

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

Provider Enumeration Date	:	03/14/2007
Last Update Date	:	07/08/2007

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