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NPI Code Detail

MEDICARE: JACOB HARRIS LEVY

MEDICARE: JACOB HARRIS LEVY
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12080P0204XPediatric Emergency Medicine (Pediatrics) Physician010267AZ

General Provider Information

NPI Number : 1811526627
Entity Type Code : Individual
Provider Name (Legal Business Name) : JACOB HARRIS LEVY
Provider Business Mailing Address
First Line : 49 JESSE HILL JR DR SE
Second Line :
City : ATLANTA
State : GA
Zip : 30303-3049
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 49 JESSE HILL JR DR SE
Second Line :
City : ATLANTA
State : GA
Zip : 30303-3049
Country : US
Telephone Number : 404-778-1440
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/03/2020
Last Update Date : 06/15/2026

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