Provider Demographics
NPI:1811333206
Name:MANNING, ANTHONY TYLER (MD)
Entity type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:TYLER
Last Name:MANNING
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:525 WESTERN AVE
Mailing Address - Street 2:STE 203
Mailing Address - City:CONWAY
Mailing Address - State:AR
Mailing Address - Zip Code:72034-4980
Mailing Address - Country:US
Mailing Address - Phone:501-327-4828
Mailing Address - Fax:501-327-6899
Practice Address - Street 1:525 WESTERN AVE
Practice Address - Street 2:STE 203
Practice Address - City:CONWAY
Practice Address - State:AR
Practice Address - Zip Code:72034-4980
Practice Address - Country:US
Practice Address - Phone:501-327-4828
Practice Address - Fax:501-327-6899
Is Sole Proprietor?:No
Enumeration Date:2013-05-13
Last Update Date:2018-06-05
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXBP10047355208600000X
ARE-10862208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery