Provider Demographics
NPI:1467150722
Name:MCELHANEY, JEFFREY
Entity Type:Individual
Prefix:
First Name:JEFFREY
Middle Name:
Last Name:MCELHANEY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3521 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MINERAL RIDGE
Mailing Address - State:OH
Mailing Address - Zip Code:44440-9711
Mailing Address - Country:US
Mailing Address - Phone:330-505-9035
Mailing Address - Fax:330-505-1012
Practice Address - Street 1:3521 MAIN ST
Practice Address - Street 2:
Practice Address - City:MINERAL RIDGE
Practice Address - State:OH
Practice Address - Zip Code:44440-9711
Practice Address - Country:US
Practice Address - Phone:330-505-9035
Practice Address - Fax:330-505-1012
Is Sole Proprietor?:No
Enumeration Date:2023-02-16
Last Update Date:2023-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor