Basic Information
Provider Information
NPI: 1679529168
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MCELHONE
FirstName: PATRICK
MiddleName: J
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 105 CHENEY ST SE
Address2:  
City: ROME
State: GA
PostalCode: 301616033
CountryCode: US
TelephoneNumber: 7062327055
FaxNumber:  
Practice Location
Address1: 501 REDMOND RD NW
Address2: ANESTHESIOLOGY DEPARTMENT
City: ROME
State: GA
PostalCode: 301651415
CountryCode: US
TelephoneNumber: 7062910291
FaxNumber:  
Other Information
ProviderEnumerationDate: 05/26/2006
LastUpdateDate: 12/03/2008
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207L00000X041891GAY Allopathic & Osteopathic PhysiciansAnesthesiology 

ID Information
IDTypeStateIssuerDescription
000707363D05GA MEDICAID
000707363C05GA MEDICAID
P0021795601GARAILROAD MEDICAREOTHER


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