MEDICARE: BRIAN GEORGE MCELHENY M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	036058838	IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1386603033
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRIAN GEORGE MCELHENY M.D.

Provider Business Mailing Address
First Line	:	PO BOX 1105
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46206-1105
Country	:	US
Telephone Number	:	618-457-5200
Fax Number	:	618-351-4821

Provider Business Practice Location Address
First Line	:	207 W JACKSON ST
Second Line	:	SUITE 101
City	:	CARBONDALE
State	:	IL
Zip	:	62901-1408
Country	:	US
Telephone Number	:	618-457-6787
Fax Number	:	618-549-9799

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/21/2006
Last Update Date	:	07/31/2013

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Directions to “ BRIAN GEORGE MCELHENY M.D.” Practice Location

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