Basic Information
| Provider Information | |||||||||
| NPI: | 1316993538 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MANNING | ||||||||
| FirstName: | CURTIS | ||||||||
| MiddleName: | E | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 103 WIND HAVEN DR | ||||||||
| Address2: | SUITE 103 | ||||||||
| City: | NICHOLASVILLE | ||||||||
| State: | KY | ||||||||
| PostalCode: | 403568025 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8002829221 | ||||||||
| FaxNumber: | 8592232732 | ||||||||
| Practice Location | |||||||||
| Address1: | 1700 OLD LEBANON RD | ||||||||
| Address2: | TAYLOR COUNTY HOSPITAL | ||||||||
| City: | CAMPBELLSVILLE | ||||||||
| State: | KY | ||||||||
| PostalCode: | 427189662 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8002829221 | ||||||||
| FaxNumber: | 8592232732 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/26/2006 | ||||||||
| LastUpdateDate: | 11/24/2009 | ||||||||
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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 | 174400000X | 21952 | KY | Y | Other Service Providers | Specialist | 2085R0202X | 21952 | KY | N | Allopathic & Osteopathic Physicians | Radiology | Diagnostic Radiology |
ID Information
| ID | Type | State | Issuer | Description | 64219520 | 05 | KY | MEDICAID |