Provider Demographics
NPI:1295750800
Name:MURRAY, THOMAS RICHARD (MD)
Entity type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:RICHARD
Last Name:MURRAY
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 1:1171 S 6TH ST STE B
Mailing Address - Street 2:
Mailing Address - City:MACCLENNY
Mailing Address - State:FL
Mailing Address - Zip Code:32063-4620
Mailing Address - Country:US
Mailing Address - Phone:904-721-5909
Mailing Address - Fax:904-204-1069
Practice Address - Street 1:1171 S 6TH ST STE B
Practice Address - Street 2:
Practice Address - City:MACCLENNY
Practice Address - State:FL
Practice Address - Zip Code:32063-4620
Practice Address - Country:US
Practice Address - Phone:904-721-5909
Practice Address - Fax:904-204-1069
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-13
Last Update Date:2025-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0060908208100000X, 2081P2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain MedicineGroup - Multi-Specialty
No208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL058114300Medicaid
FL14064OtherBLUE CROSS
FL14064OtherBLUE CROSS
FLK1231YMedicare PIN