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Individual

JONATHAN CHARLES LEVIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
27TH SPECIAL OPERATIONS MEDICAL GROUP, 224 W D. L. INGRAM AVENUE, BLDG. 1408, CANNON AFB, NM 88103-5103
(575) 784-7801
Mailing address
27TH SPECIAL OPERATIONS MEDICAL GROUP, 224 W D. L. INGRAM AVENUE, BLDG. 1408, CANNON AFB, NM 88103

Taxonomy

Speciality
Code
Description
License number
State
171000000X
Military Health Care Provider
Primary
02006642A
IN
171000000X
Military Health Care Provider

Other

Enumeration date
06/18/2017
Last updated
10/11/2024
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