MEDICARE: DR. MANCI M BALAS HOESLEY MD

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	208000000X	Pediatrics Physician	00017481	AL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	051022734	OTHER	AL	BLUE SHIELD
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	051519831	OTHER	AL	BLUE SHIELD
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	051034755	OTHER	AL	BLUE SHIELD
7	051539291	OTHER	AL	BLUE SHIELD
8	051034754	OTHER	AL	BLUE SHIELD
9	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1477522175
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MANCI M BALAS HOESLEY MD

Provider Business Mailing Address
First Line	:	3735 CORPORATE WOODS DR STE 105
Second Line	:
City	:	VESTAVIA
State	:	AL
Zip	:	35242-2296
Country	:	US
Telephone Number	:	205-900-7337
Fax Number	:	855-583-3156

Provider Business Practice Location Address
First Line	:	3735 CORPORATE WOODS DR STE 105
Second Line	:
City	:	VESTAVIA
State	:	AL
Zip	:	35242-2296
Country	:	US
Telephone Number	:	205-900-7337
Fax Number	:	855-583-3156

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/15/2006
Last Update Date	:	06/13/2023

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Directions to “ DR. MANCI M BALAS HOESLEY MD” Practice Location

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