Provider Demographics
NPI:1922041409
Name:LEVIN, BARBARA A (MD)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:A
Last Name:LEVIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1206 HIGHWAY 411
Mailing Address - Street 2:
Mailing Address - City:VONORE
Mailing Address - State:TN
Mailing Address - Zip Code:37885-2455
Mailing Address - Country:US
Mailing Address - Phone:423-884-7271
Mailing Address - Fax:423-884-3277
Practice Address - Street 1:1206 HIGHWAY 411
Practice Address - Street 2:
Practice Address - City:VONORE
Practice Address - State:TN
Practice Address - Zip Code:37885-2455
Practice Address - Country:US
Practice Address - Phone:423-884-7271
Practice Address - Fax:423-884-3277
Is Sole Proprietor?:No
Enumeration Date:2006-06-13
Last Update Date:2010-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN12266207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3177040Medicaid
TN3177044Medicaid
TN3023700OtherBLUE CROSS BLUE SHIELD #
TN3177040Medicare PIN
TNB03743Medicare UPIN
TN3177040Medicaid