MEDICARE: JONATHAN ELIOT LEVINE 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
1	207R00000X	Internal Medicine Physician	23010	OK
2	208M00000X	Hospitalist Physician	23010	OK

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	:	1558360305
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JONATHAN ELIOT LEVINE MD

Provider Business Mailing Address
First Line	:	6600 S YALE AVE
Second Line	:	STE 1400
City	:	TULSA
State	:	OK
Zip	:	74136-3310
Country	:	US
Telephone Number	:	918-488-6001
Fax Number	:

Provider Business Practice Location Address
First Line	:	6151 S YALE AVE
Second Line	:
City	:	TULSA
State	:	OK
Zip	:	74136-1907
Country	:	US
Telephone Number	:	918-494-5300
Fax Number	:	918-494-5455

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

Provider Enumeration Date	:	07/14/2005
Last Update Date	:	03/14/2018

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