Manord, Jeffrey Derrick
Manord, Jeffrey Derrick is an individual health care provider with primary practice located at 15225 Highway 43 Ste D , Russellville AL 35653-1969. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Surgery, Allopathic & Osteopathic Physicians / Vascular Surgery. Allopathic & Osteopathic Physicians / Vascular Surgery is his primary health care specialty. Manord, Jeffrey Derrick can be contacted via phone (256) 332-1500.Contact Information
Primary practice address
15225 Highway 43 Ste D
Russellville AL 35653-1969
Phone: (256) 332-1500
Fax: (256) 398-8888
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Allopathic & Osteopathic Physicians / Surgery | 208600000X | MD23436 | Alabama |
Allopathic & Osteopathic Physicians / Vascular Surgery | 2086S0129X | 23436 | Alabama |
Profile Details
NPI number | 1275587552 |
---|---|
LBN Legal business name | Manord, Jeffrey Derrick |
Credentials | Doctor of Medicine (MD) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | May 20th, 2006 |
Last updated | Mar 29th, 2022 - about 3 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1275587552 | NPPES |
Alabama | MEDICAID | 126779 | |
Alabama | Other | 511-17526 |
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