Provider Demographics
NPI:1124226980
Name:MANNING, RICHARD (MD)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:
Last Name:MANNING
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 1:313 CONCORD ST
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37919-3304
Mailing Address - Country:US
Mailing Address - Phone:865-414-4850
Mailing Address - Fax:
Practice Address - Street 1:313 CONCORD ST
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37919-3304
Practice Address - Country:US
Practice Address - Phone:865-522-5173
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD 11823207VG0400X
NC18023207VG0400X
GA030649207VG0400X
SC13803207VG0400X
ALMD 13692207VG0400X
MS11600207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC13803OtherLICENSE
GA030649OtherLICENSE
TNMD11823OtherLICENSE
ALMD13692OtherLICENSE
MS11600OtherLICENSE
NC18023OtherLICENSE