Provider Demographics
NPI:1093793838
Name:LEVINE, JAMES W (DO)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:W
Last Name:LEVINE
Suffix:
Gender:M
Credentials:DO
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Mailing Address - Street 1:1675 18TH AVE
Mailing Address - Street 2:SUITE 3
Mailing Address - City:GREELEY
Mailing Address - State:CO
Mailing Address - Zip Code:80631-5112
Mailing Address - Country:US
Mailing Address - Phone:970-350-2433
Mailing Address - Fax:970-392-4768
Practice Address - Street 1:1675 18TH AVE
Practice Address - Street 2:SUITE 3
Practice Address - City:GREELEY
Practice Address - State:CO
Practice Address - Zip Code:80631-5132
Practice Address - Country:US
Practice Address - Phone:970-350-2433
Practice Address - Fax:970-392-4768
Is Sole Proprietor?:No
Enumeration Date:2006-01-03
Last Update Date:2015-08-31
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CO42160207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
COP00944710OtherMEDICARE RAILROAD CARRIER PTAN
CO42052734Medicaid
COI02607Medicare UPIN
COC530688Medicare PIN
COCOA102137Medicare PIN