Individual
LEON MICHAEL FAVEDE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
100 3RD ST, BRIDGEPORT, OH 43912-1605
(740) 635-0814
(740) 635-2521
Mailing address
100 3RD ST, BRIDGEPORT, OH 43912-1605
(740) 635-2020
(740) 635-2521
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
4452/T1108
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0979615
—
OH
Enumeration date
10/03/2006
Last updated
03/12/2026
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