Provider Demographics
NPI:1851394522
Name:DELANEY, MICHAEL K (MD)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:K
Last Name:DELANEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7100 COMMERCE WAY
Mailing Address - Street 2:SUITE 180
Mailing Address - City:BRENTWOOD
Mailing Address - State:TN
Mailing Address - Zip Code:37027-2829
Mailing Address - Country:US
Mailing Address - Phone:615-465-7000
Mailing Address - Fax:
Practice Address - Street 1:3331 W DEYOUNG ST
Practice Address - Street 2:STE 208
Practice Address - City:MARION
Practice Address - State:IL
Practice Address - Zip Code:62959-5897
Practice Address - Country:US
Practice Address - Phone:618-997-4012
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-05-24
Last Update Date:2012-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036061952207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
D14561Medicare UPIN