Individual
BRIAN J LEVINE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1712 W ANKLAM RD, SUITE 103, TUCSON, AZ 85745-2660
(520) 622-7384
(520) 622-4899
Mailing address
PO BOX 43160, TUCSON, AZ 85733-3160
(520) 722-3777
(520) 296-6224
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
36043
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
222061
—
AZ
05
—
222087
—
AZ
01
—
36043
AZ MEDICAL LIC
AZ
Enumeration date
04/26/2007
Last updated
01/20/2009
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