=====================================================
General NPI Number Information
=====================================================
NPI Number | 1902946486
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | AIMEE LEVY MD
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/07/2007
-----------------------------------------------------
Last Update Date | 07/17/2018
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 4833 INTEGRIS PKWY STE 350
-----------------------------------------------------
City | EDMOND
-----------------------------------------------------
State | OK
-----------------------------------------------------
Zip | 73034
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 405-657-3690
-----------------------------------------------------
Fax | 405-552-5143
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 5300 N INDEPENDENCE AVE STE 280
-----------------------------------------------------
City | OKLAHOMA CITY
-----------------------------------------------------
State | OK
-----------------------------------------------------
Zip | 73112-5555
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 405-657-3690
-----------------------------------------------------
Fax | 405-552-5143
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 208600000X
-----------------------------------------------------
Taxonomy Name | Surgery Physician
-----------------------------------------------------
License Number | 24631
-----------------------------------------------------
License Number State | OK
-----------------------------------------------------