Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207K00000X | Allergist & Immunologist | MD0000005887 | TN |
NPI | 1023001781 |
---|---|
Provider Name | Dr. Joe S Levy |
First Address | Memphis, TN 38119-3863 |
Second Address | Memphis, TN 38119-3863 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/08/2005 |
Last Update Date | 22/02/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
030000450 | RAILROAD MEDICARE (01) | TN |
B02428 | (02) | TN |