Basic Information
| Provider Information | |||||||||
| NPI: | 1619916921 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MURPHY | ||||||||
| FirstName: | PAUL | ||||||||
| MiddleName: | T | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 22974 OVERSEAS HWY | ||||||||
| Address2: | |||||||||
| City: | CUDJOE KEY | ||||||||
| State: | FL | ||||||||
| PostalCode: | 330424254 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3057457357 | ||||||||
| FaxNumber: | 3057457360 | ||||||||
| Practice Location | |||||||||
| Address1: | 1200 KENNEDY DR | ||||||||
| Address2: | SUITE 100 | ||||||||
| City: | KEY WEST | ||||||||
| State: | FL | ||||||||
| PostalCode: | 330404023 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3052955568 | ||||||||
| FaxNumber: | 3052955570 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/05/2006 | ||||||||
| LastUpdateDate: | 05/20/2008 | ||||||||
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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 | 207X00000X | ME0071702 | FL | Y | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | 207XX0005X | ME71702 | FL | N | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | Sports Medicine |
ID Information
| ID | Type | State | Issuer | Description | PENDING | 01 | FL | RAILROAD MEDICARE | OTHER | 32415 | 01 | FL | BLUE CROSS BLUE SHIELD | OTHER | 264662500 | 05 | FL | MEDICAID |