Provider Demographics
NPI:1497752760
Name:MANNEY, FANI B (MD)
Entity type:Individual
Prefix:DR
First Name:FANI
Middle Name:B
Last Name:MANNEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2861
Mailing Address - Street 2:
Mailing Address - City:CROSSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:38557-2861
Mailing Address - Country:US
Mailing Address - Phone:931-200-2246
Mailing Address - Fax:931-707-9474
Practice Address - Street 1:100 S DUNCAN ST
Practice Address - Street 2:
Practice Address - City:JAMESTOWN
Practice Address - State:TN
Practice Address - Zip Code:38556-3009
Practice Address - Country:US
Practice Address - Phone:931-879-5864
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-07-01
Last Update Date:2024-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY37851208VP0014X
MS20422208VP0014X
TN613362084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY611142277OtherBLUEGRASS FAMILY HEALTH
KY000000299753OtherANTHEM
KY1280106OtherCHA
KY16363600OtherDOL
KY64067713Medicaid
KY1392787OtherUMWA
KY2162137OtherFIRSTHEALTH
KY611142277OtherCORVEL
KY611142277OtherUNITED HEALTHCARE
KY611142277WOtherHUMANA
KY611142277OtherTRICARE
KYK010972OtherCHAMPUS
KYP00029279OtherRAILROAD MCR
KY611142277OtherTRICARE
KY611142277OtherUNITED HEALTHCARE
KY64067713Medicaid