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General NPI Number Information
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NPI Number | 1649211772
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Entity Type | Individual
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Provider Name | JOHN MICHAEL MANNING JR. M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/09/2006
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Last Update Date | 01/30/2025
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Provider Practice Location Address
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Address Line | 111 FOUNTAINS BLVD.
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City | MADISON
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State | MS
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Zip | 39110
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Country | US
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Telephone | 601-707-7026
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Fax | 601-707-7054
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Provider Business Mailing Address
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Address Line | 111 FOUNTAINS BLVD
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City | MADISON
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State | MS
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Zip | 39110
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Country | US
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Telephone | 601-707-7026
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Fax | 601-707-7054
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 13190
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License Number State | MS
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Taxonomy #2
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Taxonomy Code | 207RE0101X
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Taxonomy Name | Endocrinology, Diabetes & Metabolism Physician
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License Number | 13190
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License Number State | MS
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Taxonomy #3
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Taxonomy Code | 202K00000X
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Taxonomy Name | Phlebology Physician
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License Number | 13190
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License Number State | MS
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