Provider Demographics
NPI:1437681160
Name:LEVINE, JASON ANDREW (DO)
Entity Type:Individual
Prefix:
First Name:JASON
Middle Name:ANDREW
Last Name:LEVINE
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:566 ROBINSON AVE
Mailing Address - Street 2:
Mailing Address - City:BARBERTON
Mailing Address - State:OH
Mailing Address - Zip Code:44203-3652
Mailing Address - Country:US
Mailing Address - Phone:330-753-0345
Mailing Address - Fax:330-753-0194
Practice Address - Street 1:566 ROBINSON AVE
Practice Address - Street 2:
Practice Address - City:BARBERTON
Practice Address - State:OH
Practice Address - Zip Code:44203-3652
Practice Address - Country:US
Practice Address - Phone:330-753-0345
Practice Address - Fax:330-753-0194
Is Sole Proprietor?:No
Enumeration Date:2017-03-31
Last Update Date:2021-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH390200000X
OH34.014411208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program