John Hubert Leeth III, O.D.
Individual provider Active NPI Optometrist · Waynesboro, VA
NPI 1386741973 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1386741973
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Optometrist 152W00000X
- License
- 0618000081 (VA)
- Practice address
- 400 S Magnolia Ave
Waynesboro, VA 22980-3608 - Phone
- (540) 949-7126
- Fax
- (540) 943-6170
- NPI assigned
- Sep 17, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0618000081 | VA | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Vision Tech Optometry Center Inc. | Optometrist | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 0618000081 | VA | Yes |
Addresses
Primary practice location
400 S Magnolia Ave
Waynesboro, VA 22980-3608
Mailing address
400 S Magnolia Ave
Waynesboro, VA 22980-3608
Phone (540) 949-7126
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 9230475 | Medicaid | VA |
Other providers in Waynesboro, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.