Provider Demographics
NPI:1891895017
Name:MANNTING, FINN (MD)
Entity type:Individual
Prefix:
First Name:FINN
Middle Name:
Last Name:MANNTING
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 1:8241 SUMMA AVE
Mailing Address - Street 2:SUITE D
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70809-3422
Mailing Address - Country:US
Mailing Address - Phone:225-796-9797
Mailing Address - Fax:225-769-4228
Practice Address - Street 1:5000 HENNESSY BLVD
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70808-4375
Practice Address - Country:US
Practice Address - Phone:225-765-8995
Practice Address - Fax:225-765-1299
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA14176R207U00000X
MS17479207U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207U00000XAllopathic & Osteopathic PhysiciansNuclear Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1143367Medicaid
LA4E637Medicare ID - Type Unspecified
LA1143367Medicaid