Provider Demographics
NPI:1497752760
Name:MANNEY, FANI B (MD)
Entity Type:Individual
Prefix:DR
First Name:FANI
Middle Name:B
Last Name:MANNEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:#4 DOCTORS DR
Mailing Address - Street 2:SUITE C
Mailing Address - City:OCEAN SPRINGS
Mailing Address - State:MS
Mailing Address - Zip Code:39564
Mailing Address - Country:US
Mailing Address - Phone:228-818-0053
Mailing Address - Fax:228-818-0110
Practice Address - Street 1:#4 DOCTORS DR
Practice Address - Street 2:SUITE C
Practice Address - City:OCEAN SPRINGS
Practice Address - State:MS
Practice Address - Zip Code:39564
Practice Address - Country:US
Practice Address - Phone:228-818-0053
Practice Address - Fax:228-818-0110
Is Sole Proprietor?:No
Enumeration Date:2005-07-01
Last Update Date:2010-12-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KY37851208VP0014X
MS20422208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY611142277OtherCORVEL
KY000000299753OtherANTHEM
KY611142277OtherBLUEGRASS FAMILY HEALTH
KY611142277OtherTRICARE
KY611142277WOtherHUMANA
KY1280106OtherCHA
KY64067713Medicaid
KYP00029279OtherRAILROAD MCR
KY611142277OtherUNITED HEALTHCARE
KY2162137OtherFIRSTHEALTH
KYK010972OtherCHAMPUS
KY1392787OtherUMWA
KY16363600OtherDOL
KY611142277OtherTRICARE
KY611142277OtherUNITED HEALTHCARE
KY64067713Medicaid