Individual
JONATHAN JAY LEVIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
18325 N ALLIED WAY, SUITE 100, PHOENIX, AZ 85054-3105
(602) 467-4966
(480) 419-5401
Mailing address
18325 N ALLIED WAY, SUITE 100, PHOENIX, AZ 85054-3105
(602) 467-4966
(480) 419-5401
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
51173
MN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
ENROLLED
—
IA
05
—
ENROLLED
—
MN
Enumeration date
10/26/2007
Last updated
06/04/2014
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