Provider Demographics
NPI:1588667091
Name:MANNING, JAMES A JR (MD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:A
Last Name:MANNING
Suffix:JR
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 1:508 S WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:GETTYSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17325-2594
Mailing Address - Country:US
Mailing Address - Phone:717-334-8171
Mailing Address - Fax:717-334-8172
Practice Address - Street 1:508 S WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:GETTYSBURG
Practice Address - State:PA
Practice Address - Zip Code:17325-2594
Practice Address - Country:US
Practice Address - Phone:717-334-8171
Practice Address - Fax:717-334-8172
Is Sole Proprietor?:No
Enumeration Date:2005-05-31
Last Update Date:2008-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD041451L207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0012145670002Medicaid
PA0012145670002Medicaid
PAD97513Medicare UPIN