Provider Demographics
NPI:1144271255
Name:MANLEY, JAMES WARREN (DO)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:WARREN
Last Name:MANLEY
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:1605 N CEDAR CREST BLVD
Mailing Address - Street 2:SUITE 110B
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18104-2351
Mailing Address - Country:US
Mailing Address - Phone:610-973-1410
Mailing Address - Fax:610-973-1449
Practice Address - Street 1:190 BRODHEAD RD
Practice Address - Street 2:SUITE 101
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18017-8617
Practice Address - Country:US
Practice Address - Phone:610-694-9090
Practice Address - Fax:484-403-4029
Is Sole Proprietor?:No
Enumeration Date:2006-05-13
Last Update Date:2016-08-15
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PAOS005876L207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA01210401OtherCAPITAL BLUE CROSS
PA166196OtherINTERCOUNTY
PA0000153700OtherHIGHMARK BLUE SHIELD
PA0010989870006Medicaid
PA0153700OtherKEYSTONE CENTRAL
PA20592OtherGEISINGER HEALTH PLAN
PA0092995OtherAETNA
PA080114841OtherRAILROAD MEDICARE
PA1082893OtherAMERIHEALTH MERCY
PAD71313Medicare UPIN
PA153700Medicare ID - Type Unspecified