Basic Information
| Provider Information | |||||||||
| NPI: | 1326382698 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | PHOENIX EMERGENCY SERVICES OF MURPHY PLLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3114 CROASDAILE DR | ||||||||
| Address2: | SUITE 200 | ||||||||
| City: | DURHAM | ||||||||
| State: | NC | ||||||||
| PostalCode: | 277052508 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4694012386 | ||||||||
| FaxNumber: | 9194250478 | ||||||||
| Practice Location | |||||||||
| Address1: | 3990 E US 64 ALT | ||||||||
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| City: | MURPHY | ||||||||
| State: | NC | ||||||||
| PostalCode: | 289066843 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4694012386 | ||||||||
| FaxNumber: | 9194250478 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/26/2012 | ||||||||
| LastUpdateDate: | 01/22/2015 | ||||||||
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| AuthorizedOfficialLastName: | BEHM | ||||||||
| AuthorizedOfficialFirstName: | TENNA | ||||||||
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| AuthorizedOfficialTitleorPosition: | VICE PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 4694012386 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207P00000X | NC | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Emergency Medicine |
No ID Information.