Provider Demographics
NPI:1164604922
Name:E MARILYNN FELTNER
Entity Type:Organization
Organization Name:E MARILYNN FELTNER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE PROPRIETOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:MARILYNN
Authorized Official - Last Name:FELTNER
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:304-453-5458
Mailing Address - Street 1:PO BOX 183
Mailing Address - Street 2:
Mailing Address - City:KENOVA
Mailing Address - State:WV
Mailing Address - Zip Code:25530-0183
Mailing Address - Country:US
Mailing Address - Phone:304-453-5458
Mailing Address - Fax:304-453-5459
Practice Address - Street 1:1102 POPLAR ST
Practice Address - Street 2:
Practice Address - City:KENOVA
Practice Address - State:WV
Practice Address - Zip Code:25530-1339
Practice Address - Country:US
Practice Address - Phone:304-453-5458
Practice Address - Fax:304-453-5459
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-03
Last Update Date:2007-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213EP1101XPodiatric Medicine & Surgery Service ProvidersPodiatristPrimary Podiatric MedicineGroup - Multi-Specialty
No332B00000XSuppliersDurable Medical Equipment & Medical SuppliesGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100007240Medicaid
WV2102034-000Medicaid
P00026316OtherRAILROAD MEDICARE
U94604Medicare UPIN
4907030001Medicare NSC
SP04801Medicare PIN