Provider Demographics
NPI:1154734788
Name:MANARD, JOHN (OD)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:
Last Name:MANARD
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 1:391 LINCOLN PARK DR
Mailing Address - Street 2:
Mailing Address - City:NEW LEXINGTON
Mailing Address - State:OH
Mailing Address - Zip Code:43764-1080
Mailing Address - Country:US
Mailing Address - Phone:740-342-1784
Mailing Address - Fax:
Practice Address - Street 1:391 LINCOLN PARK DR
Practice Address - Street 2:
Practice Address - City:NEW LEXINGTON
Practice Address - State:OH
Practice Address - Zip Code:43764-1080
Practice Address - Country:US
Practice Address - Phone:740-342-1784
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-06-11
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH6298152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist