Individual
GREGG B LEVY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPN
Contact information
Practice address
3325 NORTHVIEW DR, JACKSON, MS 39216-3110
(601) 213-8010
(601) 362-6124
Mailing address
3325 NORTHVIEW DR, JACKSON, MS 39216-3110
(601) 213-8010
Taxonomy
Speciality
Code
Description
License number
State
376J00000X
Homemaker
Primary
376S00000X
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00630357
—
MS
Enumeration date
06/23/2010
Last updated
06/23/2010
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