Provider Demographics
NPI:1497978340
Name:LEVY, ALAN LOUIS (MD)
Entity Type:Individual
Prefix:DR
First Name:ALAN
Middle Name:LOUIS
Last Name:LEVY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5575 POPLAR AVE
Mailing Address - Street 2:STE 708
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38119-3856
Mailing Address - Country:US
Mailing Address - Phone:901-682-0430
Mailing Address - Fax:
Practice Address - Street 1:5575 POPLAR AVE
Practice Address - Street 2:STE 708
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38119-3856
Practice Address - Country:US
Practice Address - Phone:901-682-0430
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-10
Last Update Date:2009-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN390200000X207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology