Individual
JAMIE WAYNE MANER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1001 TOWSON AVE, ER DEPT., FORT SMITH, AR 72901-4921
(479) 441-5011
(405) 749-4561
Mailing address
4401 W MEMORIAL RD, SUITE 121, OKLAHOMA CITY, OK 73134-1785
(405) 751-4664
(405) 749-4561
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
E-4182
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
157769001
—
AR
05
—
200098800A
—
OK
01
—
5N314
BCBS
AR
Enumeration date
10/24/2006
Last updated
02/13/2009
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