Provider Demographics
NPI:1477557148
Name:MANN, DARYL FRANCIS (OD)
Entity Type:Individual
Prefix:DR
First Name:DARYL
Middle Name:FRANCIS
Last Name:MANN
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7268 JARNIGAN RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37421-3097
Mailing Address - Country:US
Mailing Address - Phone:423-508-7337
Mailing Address - Fax:423-508-7338
Practice Address - Street 1:7268 JARNIGAN RD
Practice Address - Street 2:SUITE 200
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37421-3097
Practice Address - Country:US
Practice Address - Phone:423-508-7337
Practice Address - Fax:423-508-7338
Is Sole Proprietor?:No
Enumeration Date:2005-06-09
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAOPT000958152W00000X
TNOD0000000843152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3721447Medicaid
GA41ZCFLCMedicaid
TN3595482Medicaid
GAGRP6156Medicaid
GAGRP6156Medicaid
TNT61250Medicare UPIN
GA41ZCFLCMedicaid