Individual
DR. JON I LEVIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
1399 WEIMER RD, SUITE # 600, TAOS, NM 87571-6340
(575) 751-0334
(575) 751-0297
Mailing address
1399 WEIMER RD, SUITE # 600, TAOS, NM 87571-6340
(575) 751-0334
(575) 751-0297
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
A-926-91
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11348824
CAQH
—
Enumeration date
09/21/2005
Last updated
03/23/2009
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