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NPI Code Detail

MEDICARE: BRIAN G. MCELHENY, M.D. LTD

MEDICARE: BRIAN G. MCELHENY, M.D. LTD
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
1207Q00000XFamily Medicine Physician036058838IL

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
3080007297OTHERILRAILROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2207Q00000XOTHERILTAXONOMY CODE
41386603033OTHERILINDIVIDUAL NPI
51922203249OTHERILCORPORATE NPI
6114152OTHERILHEALTHLINK, INC
73900160OTHERILBLUE CROSS/BLUE SHEILD

General Provider Information

NPI Number : 1922203249
Entity Type Code : Organization
Provider Name (Legal Business Name) : BRIAN G. MCELHENY, M.D. LTD
Provider Business Mailing Address
First Line : 207 W JACKSON ST
Second Line : SUITE # 101
City : CARBONDALE
State : IL
Zip : 62901-1408
Country : US
Telephone Number : 618-457-6796
Fax Number : 618-549-9799
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 : 618-457-6796
Fax Number : 618-549-9799
Authorized Official
Title or Position : PHYSICIAN
Name : DR. BRIAN GEORGE MCELHENY, M.D. LTD
Credential : M.D.
Telephone Number : 618-457-6787
Provider Enumeration Date : 06/18/2007
Last Update Date : 07/16/2013

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