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NPI Code Detail

MEDICARE: STUART P LEVENTHAL MD

MEDICARE: STUART P LEVENTHAL MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician19158MS

General Provider Information

NPI Number : 1225047863
Entity Type Code : Individual
Provider Name (Legal Business Name) : STUART P LEVENTHAL MD
Provider Business Mailing Address
First Line : PO BOX 320863
Second Line :
City : FLOWOOD
State : MS
Zip : 39232-0863
Country : US
Telephone Number : 601-919-6590
Fax Number :
Provider Business Practice Location Address
First Line : 123 MCCOMB AVE
Second Line :
City : PORT GIBSON
State : MS
Zip : 39150-2915
Country : US
Telephone Number : 601-437-5141
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/05/2006
Last Update Date : 07/08/2007

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Directions to “ STUART P LEVENTHAL MD” Practice Location

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