MEDICARE: DR. JOY DAWN LEVERICH M.D.

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
1	208600000X	Surgery Physician	35066844	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1467423681
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOY DAWN LEVERICH M.D.

Provider Business Mailing Address
First Line	:	1552 N LIMESTONE ST
Second Line	:	STE C
City	:	GAFFNEY
State	:	SC
Zip	:	29340-4750
Country	:	US
Telephone Number	:	937-382-8500
Fax Number	:	937-382-5814

Provider Business Practice Location Address
First Line	:	600 N PICKAWAY ST
Second Line	:	SUITE 203
City	:	CIRCLEVILLE
State	:	OH
Zip	:	43113-1447
Country	:	US
Telephone Number	:	740-420-8365
Fax Number	:	740-420-8340

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/27/2006
Last Update Date	:	04/01/2016

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