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General NPI Number Information
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NPI Number | 1477086148
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Entity Type | Individual
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Provider Name | ANDERS JORDAN LEVERTON M.D.
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Gender | Male
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Dates
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Enumeration Date | 04/09/2017
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Last Update Date | 09/27/2025
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Provider Practice Location Address
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Address Line | 3501 S SONCY RD STE 1500
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City | AMARILLO
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State | TX
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Zip | 79119-6440
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Country | US
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Telephone | 806-353-7900
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Fax |
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Provider Business Mailing Address
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Address Line | 3501 S SONCY RD STE 102
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City | AMARILLO
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State | TX
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Zip | 79119-6405
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Country | US
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Telephone | 806-353-7900
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Fax | 806-353-8321
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | S3415
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License Number State | TX
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