Provider Demographics
NPI:1477676476
Name:LEVENSON, ALAN IRA (MD)
Entity Type:Individual
Prefix:
First Name:ALAN
Middle Name:IRA
Last Name:LEVENSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:6561 N AVENIDA DE POSADA
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85718-2057
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6561 N AVENIDA DE POSADA
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85718-2057
Practice Address - Country:US
Practice Address - Phone:520-795-6701
Practice Address - Fax:520-844-8181
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-06
Last Update Date:2015-05-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZ54802084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
F06683Medicare UPIN