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NPI Code Detail

MEDICARE: DR. DANIEL MILTON RUNYAN O.D.

MEDICARE: DR. DANIEL MILTON RUNYAN O.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1152W00000XOptometrist2838 T1066OH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
12220169OTHEROHUHC
2410005118OTHEROHMC RR
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
40004509000OTHEROHAETNA

General Provider Information

NPI Number : 1023176831
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DANIEL MILTON RUNYAN O.D.
Provider Business Mailing Address
First Line : 1674 N LIMESTONE ST
Second Line :
City : SPRINGFIELD
State : OH
Zip : 45503-2652
Country : US
Telephone Number : 937-322-6411
Fax Number : 937-399-2346
Provider Business Practice Location Address
First Line : 1674 N LIMESTONE ST
Second Line :
City : SPRINGFIELD
State : OH
Zip : 45503-2652
Country : US
Telephone Number : 937-322-6411
Fax Number : 937-399-2346
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/05/2006
Last Update Date : 11/28/2011

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