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General NPI Number Information
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NPI Number | 1225284136
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Entity Type | Organization
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Legal Business Name | M DIANE MCELHENEY MD
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Dates
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Enumeration Date | 08/12/2008
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Last Update Date | 08/12/2008
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Provider Practice Location Address
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Address Line | 246 MAIN ST
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City | FLORENCE
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State | KY
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Zip | 41042-2029
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Country | US
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Telephone | 859-525-7788
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Fax | 859-525-3212
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Provider Business Mailing Address
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Address Line | 246 MAIN ST
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City | FLORENCE
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State | KY
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Zip | 41042-2029
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Country | US
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Telephone | 859-525-7788
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Fax | 859-525-3212
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Authorized Official
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Title or Position | OWNER
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Name | DR. MARY DIANE MCELHENEY
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Credential | MD
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Telephone | 859-525-7788
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 15149
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License Number State | KY
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