| Leon Francis Favede, OD | |
|
100 3rd St, Bridgeport, OH 43912-1605 | |
| (740) 635-0814 | |
| (740) 635-2521 |
| Full Name | Leon Francis Favede |
|---|---|
| Gender | Male |
| Speciality | Optometrist |
| Location | 100 3rd St, Bridgeport, Ohio |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356435481 | NPI | - | NPPES |
| 2672504 | Medicaid | OH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 152W00000X | Optometrist | 2658/T427 (Ohio) | Primary |
| Provider Name | Drs. Favede & Associates |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1922192061 PECOS PAC ID: 0749307171 Enrollment ID: O20101112000847 |
| Mailing Address | Practice Location Address |
|---|---|
| Leon Francis Favede, OD 100 3rd St, Bridgeport, OH 43912-1605 Ph: (740) 635-0814 | Leon Francis Favede, OD 100 3rd St, Bridgeport, OH 43912-1605 Ph: (740) 635-0814 |
Bridgeport Eyecare Llc Optometrist Medicare: Not Enrolled in Medicare Practice Location: 100 3rd St, Bridgeport, OH 43912 Phone: 740-635-2020 | |
Leon Michael Favede, O.D. Optometrist Medicare: Accepting Medicare Assignments Practice Location: 100 3rd St, Bridgeport, OH 43912 Phone: 740-635-0814 Fax: 740-635-2521 | |
Drs. Favede & Associates Optometrist Medicare: Medicare Enrolled Practice Location: 100 Third Street, Bridgeport, OH 43912 Phone: 740-635-0814 Fax: 740-635-2521 |