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General NPI Number Information
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NPI Number | 1942732912
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Entity Type | Individual
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Provider Name | MARY HELEN MANLEY MD
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Gender | Female
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Dates
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Enumeration Date | 03/29/2017
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Last Update Date | 09/05/2025
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Provider Practice Location Address
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Address Line | 1023 NEW MOODY LN STE 202A
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City | LA GRANGE
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State | KY
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Zip | 40031-9177
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Country | US
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Telephone | 502-225-5520
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Fax | 502-225-5521
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Provider Business Mailing Address
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Address Line | 1901 CAMPUS PL
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City | LOUISVILLE
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State | KY
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Zip | 40299-2308
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Country | US
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Telephone | 502-253-4924
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Fax | 502-489-5750
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 55320
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License Number State | KY
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 55320
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License Number State | KY
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Taxonomy #3
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | R4557
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License Number State | KY
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Taxonomy #4
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | TP156
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License Number State | KY
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