Provider Demographics
NPI:1164175402
Name:MANNING, HUNTER GLENN
Entity Type:Individual
Prefix:MR
First Name:HUNTER
Middle Name:GLENN
Last Name:MANNING
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1525 E NINE MILE RD
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32514-5725
Mailing Address - Country:US
Mailing Address - Phone:850-462-6528
Mailing Address - Fax:850-462-6529
Practice Address - Street 1:2316 WALKER BLDG
Practice Address - Street 2:
Practice Address - City:AUBURN UNIVERSITY
Practice Address - State:AL
Practice Address - Zip Code:36849-5725
Practice Address - Country:US
Practice Address - Phone:334-844-8938
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-27
Last Update Date:2022-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPSI42545390200000X
ALS13459390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training ProgramGroup - Single Specialty