Provider Demographics
NPI:1891766200
Name:WILLIAM J MANNING JR MD PC
Entity Type:Organization
Organization Name:WILLIAM J MANNING JR MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROPRIETOR
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:J
Authorized Official - Last Name:MANNING
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:508-771-0169
Mailing Address - Street 1:700 ATTUCKS LANE
Mailing Address - Street 2:SUITE 1A
Mailing Address - City:HYANNIS
Mailing Address - State:MA
Mailing Address - Zip Code:02601
Mailing Address - Country:US
Mailing Address - Phone:508-771-0169
Mailing Address - Fax:508-790-1522
Practice Address - Street 1:700 ATTUCKS LANE
Practice Address - Street 2:SUITE 1A
Practice Address - City:HYANNIS
Practice Address - State:MA
Practice Address - Zip Code:02601
Practice Address - Country:US
Practice Address - Phone:508-771-0169
Practice Address - Fax:508-790-1522
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
200001225CB3802OtherRAILROAD MEDICARE
MA9700871Medicaid
MAM17544OtherBCBS
MA686920OtherTUFTS
200001225CB3802OtherRAILROAD MEDICARE