Murphy, Russell A

Murphy, Russell A is an individual health care provider with primary practice located at 1329 N Ironwood Drive , South Bend IN 46615-3566. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. Murphy, Russell A can be contacted via phone (574) 271-7500.

Contact Information

Primary practice address
1329 N Ironwood Drive South Bend IN 46615-3566
Fax: (574) 271-6052
Website:

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X 12010061A Indiana

Profile Details

NPI number 1013080019
LBN Legal business name Murphy, Russell A
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 16th, 2006
Last updated Mar 7th, 2013 - about 9 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1013080019 NPPES
Indiana MEDICAID 200205420B

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