Provider Demographics
NPI:1457369712
Name:MURPHY, THOMAS R (MD)
Entity type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:R
Last Name:MURPHY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22079 QUEBEC DR
Mailing Address - Street 2:
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97702-9215
Mailing Address - Country:US
Mailing Address - Phone:541-749-0546
Mailing Address - Fax:
Practice Address - Street 1:22079 QUEBEC DR
Practice Address - Street 2:
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97702-9215
Practice Address - Country:US
Practice Address - Phone:541-749-0546
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-03
Last Update Date:2024-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036143239207RC0200X, 207RP1001X
WI1816207RC0200X, 207RP1001X
OH35.070880207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR134073Medicaid
OR00479103OtherRAILROAD MEDICARE
OR120175Medicare ID - Type Unspecified
ORG43054Medicare UPIN