Provider Demographics
NPI:1356323901
Name:MANNING, KAREN L (MD)
Entity Type:Individual
Prefix:DR
First Name:KAREN
Middle Name:L
Last Name:MANNING
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16240 HIGHWAY 17
Mailing Address - Street 2:
Mailing Address - City:TOXEY
Mailing Address - State:AL
Mailing Address - Zip Code:36921-0000
Mailing Address - Country:US
Mailing Address - Phone:251-843-5949
Mailing Address - Fax:251-843-5969
Practice Address - Street 1:16240 HIGHWAY 17
Practice Address - Street 2:
Practice Address - City:TOXEY
Practice Address - State:AL
Practice Address - Zip Code:36921-0000
Practice Address - Country:US
Practice Address - Phone:251-843-5949
Practice Address - Fax:251-843-5969
Is Sole Proprietor?:No
Enumeration Date:2005-11-18
Last Update Date:2008-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL00022293207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL009917940Medicaid
080147288OtherRAILROAD MEDICARE
51075732OtherBLUE CROSS OF AL
000075732Medicare ID - Type Unspecified
AL009917940Medicaid