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1902841604

NPI Code Detail

MEDICARE: MURRAY S. WILLOCK M.D.

MEDICARE: MURRAY S. WILLOCK 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	35-03-1929	OH
2	207Q00000X	Family Medicine Physician	15281	WV

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
7	080040491	OTHER		RR MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	000000007060	OTHER		ANTHEM BCBS
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	001714088	OTHER		MOUNTAIN STATE BCBS
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1902841604
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MURRAY S. WILLOCK M.D.

Provider Business Mailing Address
First Line	:	90 JACKSON PIKE
Second Line	:
City	:	GALLIPOLIS
State	:	OH
Zip	:	45631-1560
Country	:	US
Telephone Number	:	304-675-4498
Fax Number	:	304-675-2103

Provider Business Practice Location Address
First Line	:	2605 JACKSON AVE
Second Line	:
City	:	POINT PLEASANT
State	:	WV
Zip	:	25550-1615
Country	:	US
Telephone Number	:	304-675-4498
Fax Number	:	304-675-8182

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

Provider Enumeration Date	:	06/17/2006
Last Update Date	:	02/09/2015

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Directions to “ MURRAY S. WILLOCK M.D.” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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