Provider Demographics
NPI:1275599946
Name:GOSSETT, DARYL DELBERT (OD)
Entity type:Individual
Prefix:DR
First Name:DARYL
Middle Name:DELBERT
Last Name:GOSSETT
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 1:498 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:NC
Mailing Address - Zip Code:28734-2901
Mailing Address - Country:US
Mailing Address - Phone:828-524-5044
Mailing Address - Fax:828-524-3549
Practice Address - Street 1:498 W MAIN ST
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:NC
Practice Address - Zip Code:28734-2901
Practice Address - Country:US
Practice Address - Phone:828-524-5044
Practice Address - Fax:828-524-3549
Is Sole Proprietor?:No
Enumeration Date:2006-04-21
Last Update Date:2009-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC0924152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC0441570001Medicare NSC