Provider Demographics
NPI:1164407292
Name:MCELHANEY, AUSTIN R JR (MD)
Entity Type:Individual
Prefix:
First Name:AUSTIN
Middle Name:R
Last Name:MCELHANEY
Suffix:JR
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 1:1330 BOILING SPRINGS RD
Mailing Address - Street 2:SUITE1200
Mailing Address - City:SPARTANBURG
Mailing Address - State:SC
Mailing Address - Zip Code:29303-2244
Mailing Address - Country:US
Mailing Address - Phone:864-591-5900
Mailing Address - Fax:
Practice Address - Street 1:1330 BOILING SPRINGS RD
Practice Address - Street 2:SUITE1200
Practice Address - City:SPARTANBURG
Practice Address - State:SC
Practice Address - Zip Code:29303-2244
Practice Address - Country:US
Practice Address - Phone:864-591-5900
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC10887207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC108877Medicaid
8352Medicare UPIN
B91839Medicare UPIN