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General NPI Number Information
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NPI Number | 1053492504
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Entity Type | Organization
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Legal Business Name | MANNING,JOHNSON & SPENCER, PA
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Dates
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Enumeration Date | 10/18/2006
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Last Update Date | 08/15/2013
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Provider Practice Location Address
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Address Line | 6823 ISAACS ORCHARD RD
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City | SPRINGDALE
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State | AR
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Zip | 72762-6096
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Country | US
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Telephone | 479-750-2080
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Fax | 479-750-2082
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Provider Business Mailing Address
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Address Line | 6823 ISAACS ORCHARD RD
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City | SPRINGDALE
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State | AR
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Zip | 72762-6096
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Country | US
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Telephone | 479-750-2080
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Fax | 479-750-2082
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Authorized Official
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Title or Position | PRESIDENT
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Name | LANCE A MANNING
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Credential | M.D.
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Telephone | 479-750-2080
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | E4334
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License Number State | AR
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