Basic Information
| Provider Information | |||||||||
| NPI: | 1790776987 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MURPHY | ||||||||
| FirstName: | TIMOTHY | ||||||||
| MiddleName: | P | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 20 CATAMORE BLVD | ||||||||
| Address2: | |||||||||
| City: | EAST PROVIDENCE | ||||||||
| State: | RI | ||||||||
| PostalCode: | 029141204 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4014322520 | ||||||||
| FaxNumber: | 4014322457 | ||||||||
| Practice Location | |||||||||
| Address1: | 20 CATAMORE BLVD | ||||||||
| Address2: | RHODE ISLAND MEDICAL IMAGING | ||||||||
| City: | EAST PROVIDENCE | ||||||||
| State: | RI | ||||||||
| PostalCode: | 029141204 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4014322520 | ||||||||
| FaxNumber: | 4014322457 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/04/2005 | ||||||||
| LastUpdateDate: | 06/17/2015 | ||||||||
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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 | 2085R0202X | 7773 | RI | N | Allopathic & Osteopathic Physicians | Radiology | Diagnostic Radiology | 2085R0204X | 07773 | RI | Y | Allopathic & Osteopathic Physicians | Radiology | Vascular & Interventional Radiology |
ID Information
| ID | Type | State | Issuer | Description | 003114915 | 01 | CT MED ASSISTANCE | OTHER | 007773 | 01 | TUFTS | OTHER | 300067428 | 01 | RAILROAD MEDICARE | OTHER | 3207773 | 01 | HEALTHY START | OTHER | 004699 | 01 | BLUE CHIP | OTHER | 7002880 | 01 | RIMEDICAL ASSISTANCE | OTHER | 720051101 | 01 | CIGNA | OTHER | 1600203 | 01 | UNITED HEALTH PLANS | OTHER | 3207773 | 01 | MASSMEDICAID | OTHER | 7773 | 01 | FEPBLUE CROSS | OTHER | 007002880 | 01 | HOSPITAL PIN | OTHER | 007773 | 01 | BLUE SHIELD | OTHER | 000000001988 | 01 | NHPRI | OTHER | 240065 | 01 | RIHPILGRIM | OTHER | 240153 | 01 | W & I PILGRIM | OTHER |