Provider Demographics
NPI:1528024437
Name:MCVAY, DONNA GAYLE (DC)
Entity Type:Individual
Prefix:DR
First Name:DONNA
Middle Name:GAYLE
Last Name:MCVAY
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:DONNA
Other - Middle Name:
Other - Last Name:MCVAY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DC
Mailing Address - Street 1:211 E YORK ST
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47872-1871
Mailing Address - Country:US
Mailing Address - Phone:765-569-3129
Mailing Address - Fax:765-569-3120
Practice Address - Street 1:211 E YORK ST
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:IN
Practice Address - Zip Code:47872-1871
Practice Address - Country:US
Practice Address - Phone:765-569-3129
Practice Address - Fax:765-569-3120
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-21
Last Update Date:2007-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN08002004A111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
000000306343OtherANTHEM
IN252840AMedicare PIN
000000306343OtherANTHEM