Daniel Dejarnatt OD

NPI 1023002458 - Optometrist - 152W00000X

NPI Details
NPI 1023002458
Gender Male
Enumeration Date 08/31/2005
Last Updated 05/29/2014
Entity Type Individual
Active Over 11 years ago
Practice Location
2300 THORNTON TAYLOR PKWY STE C
FAYETTEVILLE TN, 37334-3655, US
Phone (931) 433-3084
Fax (931) 433-4188
Business Location
2300 THORNTON TAYLOR PKWY STE C
FAYETTEVILLE TN, 37334-3655, US
Phone (931) 433-3084
Fax (931) 433-4188
Toxanomy
Taxonomy Code 152W00000X
License State Tennessee
License Number 1046
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According to our database, Daniel Dejarnatt OD NPI is 1023002458, taxonomy code is 152W00000X and license number is 1046, license state is located at Tennessee. Daniel Dejarnatt OD physically located at 2300 Thornton Taylor Pkwy Ste C, Fayetteville TN, 37334-3655. NPI Number Daniel Dejarnatt OD has the Individual type.

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1023002458 NPI number is provided on an as is basis without warranty of any kind. 1023002458 is maintained by the National Plan & Provider Enumeration System. The contents of Daniel Dejarnatt OD are for informational purposes only.