Provider Demographics
NPI:1881726925
Name:JILL MURPHEY,MD PC
Entity type:Organization
Organization Name:JILL MURPHEY,MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JILL
Authorized Official - Middle Name:STAHLHUT
Authorized Official - Last Name:MURPHEY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:573-445-2929
Mailing Address - Street 1:1801 N MAPLEVIEW DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MO
Mailing Address - Zip Code:65202-9563
Mailing Address - Country:US
Mailing Address - Phone:573-445-2929
Mailing Address - Fax:
Practice Address - Street 1:1701 E BROADWAY STE 101
Practice Address - Street 2:BROADWAY PLAZA III
Practice Address - City:COLUMBIA
Practice Address - State:MO
Practice Address - Zip Code:65201-8018
Practice Address - Country:US
Practice Address - Phone:573-815-3612
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-12
Last Update Date:2012-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO36880261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
MOE65000Medicare UPIN
MO00015197Medicare PIN