Provider Demographics
NPI:1265422174
Name:BELANY, JOHN S (DO)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:S
Last Name:BELANY
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:982 WARNER RD SE
Mailing Address - Street 2:
Mailing Address - City:BROOKFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:44403-9742
Mailing Address - Country:US
Mailing Address - Phone:330-395-2420
Mailing Address - Fax:330-395-2423
Practice Address - Street 1:311 NILES CORTLAND RD NE STE A
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:OH
Practice Address - Zip Code:44484-1949
Practice Address - Country:US
Practice Address - Phone:330-395-2420
Practice Address - Fax:330-395-2423
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-24
Last Update Date:2019-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34-00-3411-B207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0652066Medicaid
OHA 16695Medicare UPIN
OHBE 0591372Medicare ID - Type Unspecified