Provider Demographics
NPI:1740270727
Name:MCNERNEY, JAMES (DO)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:
Last Name:MCNERNEY
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 1:200 KIENLE DR
Mailing Address - Street 2:
Mailing Address - City:PIQUA
Mailing Address - State:OH
Mailing Address - Zip Code:45356-4120
Mailing Address - Country:US
Mailing Address - Phone:937-339-5355
Mailing Address - Fax:937-773-9810
Practice Address - Street 1:200 KIENLE DR
Practice Address - Street 2:
Practice Address - City:PIQUA
Practice Address - State:OH
Practice Address - Zip Code:45356-4120
Practice Address - Country:US
Practice Address - Phone:937-339-5355
Practice Address - Fax:937-773-9810
Is Sole Proprietor?:No
Enumeration Date:2005-10-21
Last Update Date:2021-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34006381M207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2008231Medicaid
OH2008231Medicaid
OHH478620Medicare PIN