Provider Demographics
NPI:1598445165
Name:POHOCSUCUT, LEVI JAPHETH (BS)
Entity Type:Individual
Prefix:
First Name:LEVI
Middle Name:JAPHETH
Last Name:POHOCSUCUT
Suffix:
Gender:M
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 729
Mailing Address - Street 2:
Mailing Address - City:ANADARKO
Mailing Address - State:OK
Mailing Address - Zip Code:73005-0729
Mailing Address - Country:US
Mailing Address - Phone:405-247-2425
Mailing Address - Fax:405-247-2430
Practice Address - Street 1:1 1/4 MILES N ON HWY 281
Practice Address - Street 2:
Practice Address - City:ANADARKO
Practice Address - State:OK
Practice Address - Zip Code:73005
Practice Address - Country:US
Practice Address - Phone:405-247-2425
Practice Address - Fax:405-247-2430
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-19
Last Update Date:2023-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator