MEDICARE: DR. KERMIT A. MURRAY 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	207Q00000X	Family Medicine Physician	41338	AZ

Other Identifiers

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

General Provider Information

NPI Number	:	1700896719
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KERMIT A. MURRAY M.D.

Provider Business Mailing Address
First Line	:	2202 N FORBES BLVD
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85745-1412
Country	:	US
Telephone Number	:	520-760-8972
Fax Number	:	520-760-3417

Provider Business Practice Location Address
First Line	:	8826 E TANQUE VERDE RD
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85749-9607
Country	:	US
Telephone Number	:	520-760-8972
Fax Number	:	520-760-3417

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

Provider Enumeration Date	:	08/09/2006
Last Update Date	:	07/22/2011

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