Provider Demographics
NPI:1932486388
Name:JOE S LEVY, M.D., P.C.
Entity Type:Organization
Organization Name:JOE S LEVY, M.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOE
Authorized Official - Middle Name:S
Authorized Official - Last Name:LEVY
Authorized Official - Suffix:
Authorized Official - Credentials:MP
Authorized Official - Phone:901-682-0430
Mailing Address - Street 1:6263 POPLAR AVE STE 525
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38119-4701
Mailing Address - Country:US
Mailing Address - Phone:901-682-0430
Mailing Address - Fax:901-680-0363
Practice Address - Street 1:6263 POPLAR AVE STE 525
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38119-4701
Practice Address - Country:US
Practice Address - Phone:901-682-0430
Practice Address - Fax:901-680-0363
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-14
Last Update Date:2019-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN05887207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1023001781OtherINDIVIDUAL NPI
TN1023001781OtherINDIVIDUAL NPI