Provider Demographics
NPI:1730185141
Name:MURPHY, JOHN ANTHONY (MD)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:ANTHONY
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 1:2450 NE MARY ROSE PL STE 220
Mailing Address - Street 2:
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97701-7133
Mailing Address - Country:US
Mailing Address - Phone:541-323-6198
Mailing Address - Fax:541-323-6249
Practice Address - Street 1:2450 NE MARY ROSE PL STE 220
Practice Address - Street 2:
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97701-7133
Practice Address - Country:US
Practice Address - Phone:541-323-6198
Practice Address - Fax:541-323-6249
Is Sole Proprietor?:No
Enumeration Date:2005-06-22
Last Update Date:2022-07-21
Deactivation Date:2006-03-18
Deactivation Code:
Reactivation Date:2006-03-27
Provider Licenses
StateLicense IDTaxonomies
ORMD22172207VX0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VX0000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyObstetrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR130284Medicaid
OR130284Medicaid
R112542Medicare ID - Type Unspecified