Doctor Name: | GREG MURRAY |
NPI Number: | 1366434839 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PA-C |
License Number: | 659 |
Business Practice Address: | 11350 Us Highway 93 S Lolo, MT - 598479689 |
Business Phone Number: | 4062730045 |
Business Fax Number: | 4067213907 |
Mailing Address: | 2360 Mullan Rd, Ste C MISSOULA |
State: | MT |
Postal Code: | 598081811 |
Phone Number: | 4067215600 |
Fax Number: | 4067213907 |
NPI Enumeration Date: | 08/19/2005 |
NPI Last Update Date: | 05/04/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363AM0700X |
License Number: | 659 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MT |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Physician Assistant |
Taxonomy Specialization: | Medical |
Taxonomy Definition: |