Provider Demographics
NPI:1265586416
Name:MCMANUS, TODD BRITTON (OD)
Entity type:Individual
Prefix:MR
First Name:TODD
Middle Name:BRITTON
Last Name:MCMANUS
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 1:302 NORTH DETROIT ST
Mailing Address - Street 2:
Mailing Address - City:XENIA
Mailing Address - State:OH
Mailing Address - Zip Code:45385
Mailing Address - Country:US
Mailing Address - Phone:937-372-6986
Mailing Address - Fax:937-372-5931
Practice Address - Street 1:302 NORTH DETROIT ST
Practice Address - Street 2:
Practice Address - City:XENIA
Practice Address - State:OH
Practice Address - Zip Code:45385
Practice Address - Country:US
Practice Address - Phone:937-372-6986
Practice Address - Fax:937-372-5931
Is Sole Proprietor?:No
Enumeration Date:2007-01-23
Last Update Date:2008-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHT2129152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2584207Medicaid
OH42273001Medicare PIN
OH5541370001Medicare NSC
U85590Medicare UPIN
OH4053959Medicare ID - Type Unspecified