Healthcare Provider Details

I. General information

NPI: 1891778460
Provider Name (Legal Business Name): JOSEPH FRANK MARANTO O.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 11/28/2005
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

550 POPE AVE MUNSON ARMY HEALTH CTR (ATTN: MCXN-COD, MS. COTTON)
FORT LEAVENWORTH KS
66027-2332
US

IV. Provider business mailing address

5008 W 128TH ST
LEAWOOD KS
66209-1880
US

V. Phone/Fax

Practice location:
  • Phone: 913-684-6562
  • Fax: 913-684-6208
Mailing address:
  • Phone: 913-897-1912
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number1434-3
License Number StateKS
# 2
Primary TaxonomyY
Taxonomy Code152WC0802X
TaxonomyCorneal and Contact Management Optometrist
License NumberT02512
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: