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General NPI Number Information
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NPI Number | 1992768485
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Entity Type | Individual
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Provider Name | BARRY MICHAEL LEVET M.D.
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Gender | Male
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Dates
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Enumeration Date | 04/07/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1000 WALTERS ST
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City | LAKE CHARLES
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State | LA
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Zip | 70607-4647
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Country | US
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Telephone | 800-962-3959
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Fax |
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Provider Business Mailing Address
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Address Line | 205 SPYGLASS LN
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City | BROUSSARD
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State | LA
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Zip | 70518-6106
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Country | US
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Telephone |
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 14632R
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License Number State | LA
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