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NPI Code Detail

MEDICARE: TAKITA M. MURRIEL M.D.

MEDICARE: TAKITA M. MURRIEL 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
1207Q00000XFamily Medicine Physician23087MS

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1578827739
Entity Type Code : Individual
Provider Name (Legal Business Name) : TAKITA M. MURRIEL M.D.
Provider Business Mailing Address
First Line : 109 HIDDEN HOLW
Second Line :
City : MADISON
State : MS
Zip : 39110-4558
Country : US
Telephone Number : 769-666-9162
Fax Number : 877-760-0717
Provider Business Practice Location Address
First Line : 4541 N STATE ST
Second Line :
City : JACKSON
State : MS
Zip : 39206-5308
Country : US
Telephone Number : 662-560-3874
Fax Number : 877-760-0717
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/02/2012
Last Update Date : 08/19/2025

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