Provider Demographics
NPI:1477993400
Name:AVON EYE DESIGN, INC.
Entity Type:Organization
Organization Name:AVON EYE DESIGN, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:J
Authorized Official - Last Name:NOVAK
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:440-934-1144
Mailing Address - Street 1:36840 DETROIT RD
Mailing Address - Street 2:
Mailing Address - City:AVON
Mailing Address - State:OH
Mailing Address - Zip Code:44011-1570
Mailing Address - Country:US
Mailing Address - Phone:440-934-1144
Mailing Address - Fax:440-548-1026
Practice Address - Street 1:36840 DETROIT RD
Practice Address - Street 2:
Practice Address - City:AVON
Practice Address - State:OH
Practice Address - Zip Code:44011-1570
Practice Address - Country:US
Practice Address - Phone:440-934-1144
Practice Address - Fax:440-934-0273
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-05
Last Update Date:2023-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOH5565152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHH209810Medicare PIN