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Individual

DR. JEFFREY S. LEVINE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
235 MEDICAL PARK BLVD, BRISTOL, TN 37620-7455
(423) 246-6777
(423) 246-7766
Mailing address
135 W RAVINE RD, SUITE 3A, KINGSPORT, TN 37660-3847
(423) 246-6777
(423) 246-7766

Taxonomy

Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
MD031443
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
005824958
VA
01
100027166
PHP TENNCARE
TN
05
1803462000
WV
01
3121717
BCBS OF TN
TN
05
3700035
TN
01
396702
ANTHEM
VA
01
5160031
AETNA
TN
05
64062763
KY
01
TN0114
UNITED HEALTHCARE RIVER V
TN
Enumeration date
09/14/2005
Last updated
05/27/2008
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