Basic Information
| Provider Information | |||||||||
| NPI: | 1245238187 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MURPHY | ||||||||
| FirstName: | THOMAS | ||||||||
| MiddleName: | J | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1500 OGLETHORPE AVE | ||||||||
| Address2: | SUITE 600A | ||||||||
| City: | ATHENS | ||||||||
| State: | GA | ||||||||
| PostalCode: | 306062179 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7064754933 | ||||||||
| FaxNumber: | 7062088259 | ||||||||
| Practice Location | |||||||||
| Address1: | 1199 PRINCE AVE | ||||||||
| Address2: | MSB 2ND FLOOR | ||||||||
| City: | ATHENS | ||||||||
| State: | GA | ||||||||
| PostalCode: | 306062797 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7064751700 | ||||||||
| FaxNumber: | 7064751790 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/13/2005 | ||||||||
| LastUpdateDate: | 10/28/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 09/06/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RC0000X | 030158 | GA | N | Allopathic & Osteopathic Physicians | Internal Medicine | Cardiovascular Disease | 207RI0011X | 030158 | GA | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Interventional Cardiology |
ID Information
| ID | Type | State | Issuer | Description | 4109855 | 01 | GA | AETNA | OTHER | 000403334G | 05 | GA | MEDICAID | 000403334H | 05 | GA | MEDICAID | 000403334K | 05 | GA | MEDICAID | 110069918 | 01 | GA | RAILORAD MEDICARE | OTHER | 000403334J | 05 | GA | MEDICAID | 000403334F | 05 | GA | MEDICAID | 000403334M | 05 | GA | MEDICAID | 00403334B | 05 | GA | MEDICAID | 1265432 | 01 | GA | UNITED HEALTHCARE | OTHER | 000403334I | 05 | GA | MEDICAID | 000403334L | 05 | GA | MEDICAID | 0451334 | 01 | GA | BLUE SHIELD | OTHER |