Provider Demographics
NPI:1730560228
Name:MURTHA, ANDREW SCOTT (MD)
Entity type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:SCOTT
Last Name:MURTHA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:KEESLER MEDICAL CENTER
Mailing Address - Street 2:301 FISHER STREET
Mailing Address - City:KEESLER AFB
Mailing Address - State:MS
Mailing Address - Zip Code:39534
Mailing Address - Country:US
Mailing Address - Phone:228-376-3059
Mailing Address - Fax:228-376-0101
Practice Address - Street 1:KEESLER MEDICAL CENTER
Practice Address - Street 2:301 FISHER STREET
Practice Address - City:KEESLER AFB
Practice Address - State:MS
Practice Address - Zip Code:39534
Practice Address - Country:US
Practice Address - Phone:228-376-3059
Practice Address - Fax:228-376-0101
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-10
Last Update Date:2021-10-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NE29382207X00000X
KS0443770207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS201313050AMedicaid