Provider Demographics
NPI:1013094028
Name:LEVINE, JON HOWARD (MD)
Entity Type:Individual
Prefix:DR
First Name:JON
Middle Name:HOWARD
Last Name:LEVINE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:2222 STATE ST
Mailing Address - Street 2:SUITE C
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37203-1845
Mailing Address - Country:US
Mailing Address - Phone:615-329-0131
Mailing Address - Fax:615-329-1611
Practice Address - Street 1:2222 STATE ST
Practice Address - Street 2:SUITE C
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37203-1845
Practice Address - Country:US
Practice Address - Phone:615-329-0131
Practice Address - Fax:615-329-1611
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2011-02-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TN20148207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
TND099392Medicare UPIN
TN3729494Medicare ID - Type UnspecifiedGROUP
TN3048830Medicare ID - Type UnspecifiedINDIVIDUAL