Individual
EDWARD MANNING
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
2500 NORTH STATE STREET, DEPT OF NEUROLOGY, JACKSON, MS 39216
(601) 984-5500
(601) 984-5499
Mailing address
PO BOX 11407, DEPT # 2130, BIRMINGHAM, AL 35246-2130
(601) 984-5500
(601) 984-5499
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
25-324
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0110219
—
MS
05
—
1676608
—
LA
Enumeration date
07/31/2006
Last updated
02/01/2013
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