Provider Demographics
NPI:1174616924
Name:MURRAY, WILLIAM D (OD)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:D
Last Name:MURRAY
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 1:20 S HIGH ST
Mailing Address - Street 2:
Mailing Address - City:CANAL WINCHESTER
Mailing Address - State:OH
Mailing Address - Zip Code:43110-1251
Mailing Address - Country:US
Mailing Address - Phone:614-837-7725
Mailing Address - Fax:614-837-7301
Practice Address - Street 1:5555 HILLIARD ROME OFFICE PARK
Practice Address - Street 2:
Practice Address - City:HILLIARD
Practice Address - State:OH
Practice Address - Zip Code:43026-7287
Practice Address - Country:US
Practice Address - Phone:614-777-1111
Practice Address - Fax:614-777-7920
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2016-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH4577 T1320152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0030933Medicaid
OHU53043Medicare UPIN
OHMC-4052631Medicare PIN
OH0030933Medicaid
4052632Medicare PIN