Basic Information
| Provider Information | |||||||||
| NPI: | 1952553927 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | MURRAY PEDIATRICS | ||||||||
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| Mailing Information | |||||||||
| Address1: | 300 S 8TH ST STE 208E | ||||||||
| Address2: | |||||||||
| City: | MURRAY | ||||||||
| State: | KY | ||||||||
| PostalCode: | 420712472 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2707599223 | ||||||||
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| Practice Location | |||||||||
| Address1: | 300 S 8TH ST STE 208E | ||||||||
| Address2: | |||||||||
| City: | MURRAY | ||||||||
| State: | KY | ||||||||
| PostalCode: | 420712472 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2707599223 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 10/21/2008 | ||||||||
| LastUpdateDate: | 01/11/2013 | ||||||||
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| AuthorizedOfficialLastName: | AUSTIN | ||||||||
| AuthorizedOfficialFirstName: | CLEGG | ||||||||
| AuthorizedOfficialMiddleName: | F | ||||||||
| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 2707599223 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363L00000X | Y | 193400000X SINGLE SPECIALTY GROUP | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner |
No ID Information.