Individual
DR. MARK B MCHANEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
400 N STATE OF FRANKLIN RD, JOHNSON CITY, TN 37604-6035
(423) 431-6111
Mailing address
200 CORPORATE BLVD, LAFAYETTE, LA 70508-3870
(800) 893-9698
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
50515
TN
208000000X
Pediatrics Physician
101058204
VA
208000000X
Pediatrics Physician
Primary
50515
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
006730876
—
VA
01
—
265478
ANTHEM
VA
01
—
541777838
TAX ID
—
Enumeration date
12/01/2006
Last updated
03/07/2023
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