Healthcare Provider Details

I. General information

NPI: 1760431225
Provider Name (Legal Business Name): ERNESTO N LEVY M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: ERNESTO LEVY MD

II. Dates (important events)

Enumeration Date: 05/10/2006
Last Update Date: 10/15/2024
Certification Date: 10/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1015 N SHARTEL AVE
OKLAHOMA CITY OK
73102-1021
US

IV. Provider business mailing address

1015 N SHARTEL AVENUE
OKLAHOMA CITY OK
73102-1021
US

V. Phone/Fax

Practice location:
  • Phone: 405-606-8070
  • Fax: 405-606-6350
Mailing address:
  • Phone: 405-606-8070
  • Fax: 405-606-6350

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License Number83470
License Number StateSC
# 2
Primary TaxonomyN
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License Number01064370A
License Number StateIN
# 3
Primary TaxonomyN
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License NumberMD423583
License Number StatePA
# 4
Primary TaxonomyN
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License Number263037
License Number StateNY
# 5
Primary TaxonomyN
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License NumberMD23773
License Number StateME
# 6
Primary TaxonomyN
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License Number100125
License Number StateMO
# 7
Primary TaxonomyN
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License Number55071
License Number StateAZ
# 8
Primary TaxonomyN
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License Number343231
License Number StateLA
# 9
Primary TaxonomyY
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License Number40813
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: