Provider Demographics
NPI:1093455941
Name:VALLERY, ANTHONY R (DO)
Entity Type:Individual
Prefix:
First Name:ANTHONY
Middle Name:R
Last Name:VALLERY
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:455 SHAWNEE LN
Mailing Address - Street 2:
Mailing Address - City:CHILLICOTHE
Mailing Address - State:OH
Mailing Address - Zip Code:45601-4145
Mailing Address - Country:US
Mailing Address - Phone:740-779-4888
Mailing Address - Fax:
Practice Address - Street 1:455 SHAWNEE LN
Practice Address - Street 2:
Practice Address - City:CHILLICOTHE
Practice Address - State:OH
Practice Address - Zip Code:45601-4145
Practice Address - Country:US
Practice Address - Phone:740-779-4888
Practice Address - Fax:740-779-4898
Is Sole Proprietor?:No
Enumeration Date:2022-03-30
Last Update Date:2023-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH58.0327692084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry