Provider Demographics
NPI:1225284136
Name:M DIANE MCELHENEY MD
Entity Type:Organization
Organization Name:M DIANE MCELHENEY MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARY
Authorized Official - Middle Name:DIANE
Authorized Official - Last Name:MCELHENEY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:859-525-7788
Mailing Address - Street 1:246 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:KY
Mailing Address - Zip Code:41042-2029
Mailing Address - Country:US
Mailing Address - Phone:859-525-7788
Mailing Address - Fax:859-525-3212
Practice Address - Street 1:246 MAIN ST
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:KY
Practice Address - Zip Code:41042-2029
Practice Address - Country:US
Practice Address - Phone:859-525-7788
Practice Address - Fax:859-525-3212
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-12
Last Update Date:2008-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY151492084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0446093Medicaid
KY64151491Medicaid
KY1206001Medicare PIN
KYD32227Medicare UPIN