Provider Demographics
NPI:1205860228
Name:MANAZER, JAMES R (MD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:R
Last Name:MANAZER
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:272 HOSPITAL RD
Mailing Address - Street 2:SUITE 3
Mailing Address - City:CHILLICOTHE
Mailing Address - State:OH
Mailing Address - Zip Code:45601-9031
Mailing Address - Country:US
Mailing Address - Phone:740-779-8234
Mailing Address - Fax:740-779-7477
Practice Address - Street 1:4439 STATE ROUTE 159
Practice Address - Street 2:STE 130
Practice Address - City:CHILLICOTHE
Practice Address - State:OH
Practice Address - Zip Code:45601-8207
Practice Address - Country:US
Practice Address - Phone:740-779-4360
Practice Address - Fax:740-779-4369
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2020-12-28
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
OH35.087566208600000X
OH350875662086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
No208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2663470Medicaid
I55773Medicare UPIN
OH2663470Medicaid
MA7357301Medicare PIN