Individual
MR. CLOVIS E MANLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4943 ROSEBUD LN, NEWBURGH, IN 47630-9226
(812) 471-8195
(812) 490-1060
Mailing address
4943 ROSEBUD LN, NEWBURGH, IN 47630-9226
(812) 471-8195
(812) 490-1060
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01036788
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000843235
ANTHEM
IN
05
—
100085380
—
IN
01
—
P01263645
RAILROAD MEDICARE
IN
Enumeration date
11/16/2006
Last updated
02/19/2024
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