Provider Demographics
NPI:1447202205
Name:CHANEY, JAMES ALVIN (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:ALVIN
Last Name:CHANEY
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 1:181 ROY CAMPBELL DRIVE
Mailing Address - Street 2:
Mailing Address - City:HAZARD
Mailing Address - State:KY
Mailing Address - Zip Code:41701
Mailing Address - Country:US
Mailing Address - Phone:606-439-3223
Mailing Address - Fax:606-439-7417
Practice Address - Street 1:181 ROY CAMPBELL DRIVE
Practice Address - Street 2:
Practice Address - City:HAZARD
Practice Address - State:KY
Practice Address - Zip Code:41701
Practice Address - Country:US
Practice Address - Phone:606-439-3223
Practice Address - Fax:606-439-7417
Is Sole Proprietor?:No
Enumeration Date:2006-05-17
Last Update Date:2013-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY28914207R00000X, 208VP0014X, 208VP0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
No208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY64289143Medicaid
KY65945461OtherMEDICAID GROUP #
KY000000485374OtherANTHEM GROUP NUMBER
KY0751OtherMEDICARE FACILITY GROUP NUMBER
KY1780728881OtherMEDICARE PHYSICIAN GROUP NUMBER
KY1780728881OtherMEDICARE PHYSICIAN GROUP NUMBER
KY65945461OtherMEDICAID GROUP #