Provider Demographics
NPI:1265659791
Name:LEVIN FAMILY PRACTICE, PC
Entity Type:Organization
Organization Name:LEVIN FAMILY PRACTICE, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DEBRA
Authorized Official - Middle Name:K
Authorized Official - Last Name:LEVIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:770-569-2020
Mailing Address - Street 1:1040 CAMBRIDGE SQ
Mailing Address - Street 2:SUITE E
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30004-1800
Mailing Address - Country:US
Mailing Address - Phone:770-569-2020
Mailing Address - Fax:770-569-5550
Practice Address - Street 1:1040 CAMBRIDGE SQ
Practice Address - Street 2:SUITE E
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30004-1800
Practice Address - Country:US
Practice Address - Phone:770-569-2020
Practice Address - Fax:770-569-5550
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA020932207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1518959964OtherNPI DEBRA K LEVIN, MD
1053303446OtherNPI STUART I LEVIN, MD