MEDICARE: VALERIE B MANNING DO PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207QA0505X	Adult Medicine Physician	3811	OK

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1275518367
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VALERIE B MANNING DO PLLC

Provider Business Mailing Address
First Line	:	3330 NW 56TH STREET
Second Line	:	SUITE 305
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73112-4426
Country	:	US
Telephone Number	:	405-945-5240
Fax Number	:	405-945-5263

Provider Business Practice Location Address
First Line	:	3330 NW 56TH ST
Second Line	:	SUITE 305
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73112-4479
Country	:	US
Telephone Number	:	405-945-5240
Fax Number	:	405-945-5263

Authorized Official
Title or Position	:	PHYSICIAN
Name	:	DR. VALERIE B MANNING
Credential	:	DO
Telephone Number	:	405-945-5240

Provider Enumeration Date	:	12/12/2005
Last Update Date	:	08/31/2012

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