Provider Demographics
NPI:1073599908
Name:LEVIN, ANTHONY S (DO)
Entity Type:Individual
Prefix:
First Name:ANTHONY
Middle Name:S
Last Name:LEVIN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:3003 N CENTRAL AVE STE 1175
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85012-0002
Mailing Address - Country:US
Mailing Address - Phone:888-698-6727
Mailing Address - Fax:602-564-6246
Practice Address - Street 1:2435 E GREENWAY PKWY
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85032-3591
Practice Address - Country:US
Practice Address - Phone:602-755-0800
Practice Address - Fax:602-560-2721
Is Sole Proprietor?:No
Enumeration Date:2005-12-22
Last Update Date:2022-06-23
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PAOS006973L207Q00000X
AZ009369207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0014726410003Medicaid
PA0014726410003Medicaid
PA699958MVFMedicare PIN