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General NPI Number Information
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NPI Number | 1811652472
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Entity Type | Individual
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Provider Name | STANLEY S LEVINSON PH.D., DABCC
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Gender | Male
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Dates
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Enumeration Date | 11/08/2021
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Last Update Date | 11/08/2021
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Provider Practice Location Address
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Address Line | 7386 WOLFSPRING TRCE
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City | LOUISVILLE
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State | KY
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Zip | 40241-1056
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Country | US
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Telephone | 502-876-0863
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Fax |
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Provider Business Mailing Address
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Address Line | 7386 WOLFSPRING TRCE
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City | LOUISVILLE
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State | KY
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Zip | 40241-1056
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Country | US
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Telephone | 502-876-0863
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Fax |
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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 | 207ZP0104X
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Taxonomy Name | Chemical Pathology Physician
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License Number | 610
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License Number State | DE
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