Provider Demographics
NPI:1447437132
Name:TODD MCMANUS OD & ASSOC INC
Entity type:Organization
Organization Name:TODD MCMANUS OD & ASSOC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TODD
Authorized Official - Middle Name:BRITTON
Authorized Official - Last Name:MCMANUS
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:937-864-2831
Mailing Address - Street 1:31 REBERT PIKE
Mailing Address - Street 2:
Mailing Address - City:ENON
Mailing Address - State:OH
Mailing Address - Zip Code:45323-1826
Mailing Address - Country:US
Mailing Address - Phone:937-864-2831
Mailing Address - Fax:937-864-1197
Practice Address - Street 1:31 REBERT PIKE
Practice Address - Street 2:
Practice Address - City:ENON
Practice Address - State:OH
Practice Address - Zip Code:45323-1826
Practice Address - Country:US
Practice Address - Phone:937-864-2831
Practice Address - Fax:937-864-1197
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-25
Last Update Date:2008-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH5225/T2129152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2584207Medicaid
OH2584207Medicaid
OH4227301Medicare PIN