Provider Demographics
NPI:1033213665
Name:LEVY HYPERBARIC AND WOUND CARE SPECIALISTS, LLC.
Entity Type:Organization
Organization Name:LEVY HYPERBARIC AND WOUND CARE SPECIALISTS, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SION
Authorized Official - Middle Name:
Authorized Official - Last Name:LEVY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:314-205-6818
Mailing Address - Street 1:PO BOX 220605
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63122-0605
Mailing Address - Country:US
Mailing Address - Phone:314-205-6818
Mailing Address - Fax:314-205-6770
Practice Address - Street 1:111 SAINT LUKES CENTER DR STE 10B
Practice Address - Street 2:
Practice Address - City:CHESTERFIELD
Practice Address - State:MO
Practice Address - Zip Code:63017-3509
Practice Address - Country:US
Practice Address - Phone:314-205-6818
Practice Address - Fax:314-205-6770
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-12
Last Update Date:2019-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20050162062083P0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2083P0011XAllopathic & Osteopathic PhysiciansPreventive MedicineUndersea and Hyperbaric MedicineGroup - Single Specialty