Provider Demographics
NPI:1780731794
Name:MANNING-COURTNEY, PATRICIA MARY (MD)
Entity type:Individual
Prefix:DR
First Name:PATRICIA
Middle Name:MARY
Last Name:MANNING-COURTNEY
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 1:3430 BURNET AVE.
Mailing Address - Street 2:MLC 4002
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45229-3026
Mailing Address - Country:US
Mailing Address - Phone:513-363-4611
Mailing Address - Fax:513-636-3800
Practice Address - Street 1:3430 BURNET AVE.
Practice Address - Street 2:MLC 4002
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45229-3026
Practice Address - Country:US
Practice Address - Phone:513-363-4611
Practice Address - Fax:513-636-3800
Is Sole Proprietor?:No
Enumeration Date:2007-01-04
Last Update Date:2015-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH350677082080P0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0006XAllopathic & Osteopathic PhysiciansPediatricsDevelopmental - Behavioral Pediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2049045Medicaid
KY64329279Medicaid
WV1000382-000Medicaid
IN200242500AMedicaid
H98592Medicare UPIN
OH2049045Medicaid