Basic Information
Provider Information
NPI: 1407241656
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MURPHY
FirstName: JOEL
MiddleName: DANIEL
NamePrefix:  
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Credential:  
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Mailing Information
Address1: 10810 EXECUTIVE CENTER DR STE 100
Address2:  
City: LITTLE ROCK
State: AR
PostalCode: 722114386
CountryCode: US
TelephoneNumber: 5016042695
FaxNumber: 5016042699
Practice Location
Address1: 10810 EXECUTIVE CENTER DR STE 100
Address2:  
City: LITTLE ROCK
State: AR
PostalCode: 722114386
CountryCode: US
TelephoneNumber: 5016042695
FaxNumber: 5016042699
Other Information
ProviderEnumerationDate: 04/04/2015
LastUpdateDate: 08/16/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
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IsSoleProprietor: N
IsOrganizationSubpart:  
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AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 08/16/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
390200000X VAN Student, Health CareStudent in an Organized Health Care Education/Training Program 
207ZP0102XE-12794ARY Allopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology

No ID Information.


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