Individual
JEFFREY P. LEVENDA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
7980 W JEFFERSON BLVD, FORT WAYNE, IN 46804-4170
(260) 478-5210
(260) 478-5240
Mailing address
6920 POINTE INVERNESS WAY STE 200, FORT WAYNE, IN 46804-7934
(260) 479-3516
(260) 479-3520
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01070886
IN
207QS0010X
Sports Medicine (Family Medicine) Physician
01070886A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201063910
—
IN
Enumeration date
06/15/2010
Last updated
03/30/2026
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