Basic Information
| Provider Information | |||||||||
| NPI: | 1205984416 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MURPHY | ||||||||
| FirstName: | ROBERT | ||||||||
| MiddleName: | BRYAN | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5196 HILL RD E STE 300 | ||||||||
| Address2: | |||||||||
| City: | LAKEPORT | ||||||||
| State: | CA | ||||||||
| PostalCode: | 954536374 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7072636885 | ||||||||
| FaxNumber: | 7072636624 | ||||||||
| Practice Location | |||||||||
| Address1: | 5196 HILL RD E STE 300 | ||||||||
| Address2: | |||||||||
| City: | LAKEPORT | ||||||||
| State: | CA | ||||||||
| PostalCode: | 95453 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7072636885 | ||||||||
| FaxNumber: | 7072636624 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/08/2007 | ||||||||
| LastUpdateDate: | 06/05/2018 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207V00000X | 2010-01041 | NC | N | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | 207V00000X | MD42586 | TN | N | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | 207V00000X | C149327 | CA | Y | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology |
ID Information
| ID | Type | State | Issuer | Description | 4205901 | 01 | TN | BLUE CROSS | OTHER |