Basic Information
| Provider Information | |||||||||
| NPI: | 1164701447 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | MURRAY ANESTHETISTS GROUP, PLLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 632 N 12TH ST # 230 | ||||||||
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| City: | MURRAY | ||||||||
| State: | KY | ||||||||
| PostalCode: | 420711651 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2707486851 | ||||||||
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| Practice Location | |||||||||
| Address1: | 803 POPLAR STREET | ||||||||
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| City: | MURRAY | ||||||||
| State: | KY | ||||||||
| PostalCode: | 420712432 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2707621100 | ||||||||
| FaxNumber: | 2707621586 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/04/2011 | ||||||||
| LastUpdateDate: | 05/24/2016 | ||||||||
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| AuthorizedOfficialLastName: | GREEN | ||||||||
| AuthorizedOfficialFirstName: | JENNIFER | ||||||||
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| AuthorizedOfficialTitleorPosition: | BUSINESS MANAGER | ||||||||
| AuthorizedOfficialTelephone: | 2707486851 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MRS. | ||||||||
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| AuthorizedOfficialCredential: | CRNA | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 367500000X | KY | Y | 193400000X SINGLE SPECIALTY GROUP | Physician Assistants & Advanced Practice Nursing Providers | Nurse Anesthetist, Certified Registered |
No ID Information.