Provider Demographics
NPI:1538236880
Name:MURPHY, CARTER L (OD)
Entity type:Individual
Prefix:
First Name:CARTER
Middle Name:L
Last Name:MURPHY
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5251 JOHN TYLER HWY STE 7
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:23185-8808
Mailing Address - Country:US
Mailing Address - Phone:757-229-8660
Mailing Address - Fax:757-258-8845
Practice Address - Street 1:5251 JOHN TYLER HWY STE 7
Practice Address - Street 2:
Practice Address - City:WILLIAMSBURG
Practice Address - State:VA
Practice Address - Zip Code:23185-8808
Practice Address - Country:US
Practice Address - Phone:757-229-8660
Practice Address - Fax:757-258-8845
Is Sole Proprietor?:No
Enumeration Date:2006-11-30
Last Update Date:2010-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0601000591152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA9203257Medicaid
VA9203257Medicaid
VA0890080001Medicare NSC
VAT21996Medicare UPIN