Individual
PATTI MANNING
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2520 5TH ST N, COLUMBUS, MS 39705-2008
(904) 805-1300
(904) 805-1302
Mailing address
PO BOX 75473, BALTIMORE, MD 21275-5473
(904) 805-1300
(904) 805-1302
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
12861
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00018196
—
MS
01
—
7306313MAN
ALABAMA BLUE CROSS
MS
01
—
P00213723
RAILROAD MEDICARE
MS
Enumeration date
06/13/2006
Last updated
07/08/2007
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