Provider Demographics
NPI:1275519050
Name:MCELDOWNEY, ANTHONY J (MD)
Entity Type:Individual
Prefix:
First Name:ANTHONY
Middle Name:J
Last Name:MCELDOWNEY
Suffix:
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 1:122 PINNELL ST
Mailing Address - Street 2:
Mailing Address - City:RIPLEY
Mailing Address - State:WV
Mailing Address - Zip Code:25271-9101
Mailing Address - Country:US
Mailing Address - Phone:304-373-1578
Mailing Address - Fax:304-373-1598
Practice Address - Street 1:122 PINNELL ST
Practice Address - Street 2:
Practice Address - City:RIPLEY
Practice Address - State:WV
Practice Address - Zip Code:25271-9101
Practice Address - Country:US
Practice Address - Phone:304-373-1578
Practice Address - Fax:304-373-1598
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-22
Last Update Date:2008-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV21767208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2585671Medicaid
WV3810001563OtherWELFARE
OH2585671Medicaid
WV513410Medicare Oscar/Certification
WV5100181Medicare Oscar/Certification
WVMC7381541Medicare PIN