Basic Information
| Provider Information | |||||||||
| NPI: | 1144271255 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MANLEY | ||||||||
| FirstName: | JAMES | ||||||||
| MiddleName: | WARREN | ||||||||
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| Credential: | DO | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1605 N CEDAR CREST BLVD | ||||||||
| Address2: | SUITE 110B | ||||||||
| City: | ALLENTOWN | ||||||||
| State: | PA | ||||||||
| PostalCode: | 181042351 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6109731410 | ||||||||
| FaxNumber: | 6109731449 | ||||||||
| Practice Location | |||||||||
| Address1: | 190 BRODHEAD RD | ||||||||
| Address2: | SUITE 101 | ||||||||
| City: | BETHLEHEM | ||||||||
| State: | PA | ||||||||
| PostalCode: | 180178617 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6106949090 | ||||||||
| FaxNumber: | 4844034029 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/13/2006 | ||||||||
| LastUpdateDate: | 08/15/2016 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | OS005876L | PA | Y | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | 01210401 | 01 | PA | CAPITAL BLUE CROSS | OTHER | 166196 | 01 | PA | INTERCOUNTY | OTHER | 0000153700 | 01 | PA | HIGHMARK BLUE SHIELD | OTHER | 0010989870006 | 05 | PA | MEDICAID | 0153700 | 01 | PA | KEYSTONE CENTRAL | OTHER | 20592 | 01 | PA | GEISINGER HEALTH PLAN | OTHER | 0092995 | 01 | PA | AETNA | OTHER | 080114841 | 01 | PA | RAILROAD MEDICARE | OTHER | 1082893 | 01 | PA | AMERIHEALTH MERCY | OTHER |