Provider Demographics
NPI:1619162237
Name:MCCLANAHAN, ERIC SCOTT (DO)
Entity Type:Individual
Prefix:DR
First Name:ERIC
Middle Name:SCOTT
Last Name:MCCLANAHAN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:512 CHERRY ST
Mailing Address - Street 2:BUILDING I
Mailing Address - City:BLUEFIELD
Mailing Address - State:WV
Mailing Address - Zip Code:24701-3341
Mailing Address - Country:US
Mailing Address - Phone:304-324-2715
Mailing Address - Fax:304-324-2774
Practice Address - Street 1:512 CHERRY ST
Practice Address - Street 2:BUILDING I
Practice Address - City:BLUEFIELD
Practice Address - State:WV
Practice Address - Zip Code:24701-3341
Practice Address - Country:US
Practice Address - Phone:304-324-2715
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-09-06
Last Update Date:2012-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV2328207R00000X
VA0102202507207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine