Provider Demographics
NPI:1013956861
Name:MCELROY, JAMES A (MD FACS)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:A
Last Name:MCELROY
Suffix:
Gender:M
Credentials:MD FACS
Other - Prefix:
Other - First Name:J
Other - Middle Name:ALLEN
Other - Last Name:MCELROY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD FACS
Mailing Address - Street 1:PO BOX 449
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:OH
Mailing Address - Zip Code:45750-0449
Mailing Address - Country:US
Mailing Address - Phone:740-374-4500
Mailing Address - Fax:740-374-5887
Practice Address - Street 1:400 MATTHEW ST
Practice Address - Street 2:STE 401
Practice Address - City:MARIETTA
Practice Address - State:OH
Practice Address - Zip Code:45750-1662
Practice Address - Country:US
Practice Address - Phone:740-374-2252
Practice Address - Fax:740-374-4974
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-06
Last Update Date:2020-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35073417M208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000696938OtherANTHEM
OH2206348Medicaid
WV1000127000Medicaid
OHP00475910OtherRRMCR
OH000000490580OtherANTHEM
H27729Medicare UPIN
4036713Medicare PIN
OH000000696938OtherANTHEM