MEDICARE: MR. WILLIAM HOUSTON MURPHY COTA/L

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	224Z00000X	Occupational Therapy Assistant	OTA0000002309	TN

General Provider Information

NPI Number	:	1821477019
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. WILLIAM HOUSTON MURPHY COTA/L

Provider Business Mailing Address
First Line	:	129 SHERIDAN CIR
Second Line	:
City	:	OAK RIDGE
State	:	TN
Zip	:	37830-4744
Country	:	US
Telephone Number	:	865-405-5660
Fax Number	:

Provider Business Practice Location Address
First Line	:	129 SHERIDAN CIR
Second Line	:
City	:	OAK RIDGE
State	:	TN
Zip	:	37830-4744
Country	:	US
Telephone Number	:	865-405-5660
Fax Number	:

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

Provider Enumeration Date	:	05/21/2015
Last Update Date	:	05/21/2015

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