Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207VG0400X | Gynecologist | 030649 | GA |
N | 207VG0400X | Gynecologist | 11600 | MS |
N | 207VG0400X | Gynecologist | 13803 | SC |
N | 207VG0400X | Gynecologist | 18023 | NC |
Y | 207VG0400X | Gynecologist | MD 11823 | TN |
N | 207VG0400X | Gynecologist | MD 13692 | AL |
NPI | 1124226980 |
---|---|
Provider Name | Richard Manning |
First Address | Knoxville, TN 37919-3304 |
Second Address | Knoxville, TN 37919-3304 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/07/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
030649 | LICENSE (01) | GA |
11600 | LICENSE (01) | MS |
13803 | LICENSE (01) | SC |
18023 | LICENSE (01) | NC |
MD11823 | LICENSE (01) | TN |
MD13692 | LICENSE (01) | AL |