Provider Demographics
NPI:1427196575
Name:MURDOCK, CHAD LEWIS (MD)
Entity type:Individual
Prefix:
First Name:CHAD
Middle Name:LEWIS
Last Name:MURDOCK
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 1:5051 ORCHID DR
Mailing Address - Street 2:
Mailing Address - City:WEST LAFAYETTE
Mailing Address - State:IN
Mailing Address - Zip Code:47906-9071
Mailing Address - Country:US
Mailing Address - Phone:208-881-2037
Mailing Address - Fax:765-807-3081
Practice Address - Street 1:3062 CHURN CREEK RD
Practice Address - Street 2:
Practice Address - City:REDDING
Practice Address - State:CA
Practice Address - Zip Code:96002-2124
Practice Address - Country:US
Practice Address - Phone:530-221-0976
Practice Address - Fax:530-223-4866
Is Sole Proprietor?:No
Enumeration Date:2007-02-01
Last Update Date:2025-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDM-75132084P0800X, 2084P0804X
CAA1217042084P0800X
IN01080930A2084P0804X, 2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN3000029233Medicaid