1922102466 NPI number — DOCTORS PHIPPS, LEVIN, HEBEKA, AND ASSOCIATES, LTD

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1922102466 NPI number — DOCTORS PHIPPS, LEVIN, HEBEKA, AND ASSOCIATES, LTD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
DOCTORS PHIPPS, LEVIN, HEBEKA, AND ASSOCIATES, LTD
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
PHIPPS, LEVIN, & HEBEKA
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1922102466
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
970 W WOOSTER ST
Provider Second Line Business Mailing Address:
SUITE 125
Provider Business Mailing Address City Name:
BOWLING GREEN
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
43402-2643
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
419-352-2569
Provider Business Mailing Address Fax Number:
419-352-8308

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
970 W WOOSTER ST
Provider Second Line Business Practice Location Address:
SUITE 125
Provider Business Practice Location Address City Name:
BOWLING GREEN
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
43402-2643
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
419-352-2569
Provider Business Practice Location Address Fax Number:
419-352-8308
Provider Enumeration Date:
09/12/2006

Additional Information

Authorized Official

Authorized Official Last Name:
LEVIN
Authorized Official First Name:
JEFFREY
Authorized Official Middle Name:
J
Authorized Official Title or Position:
MANAGING PARTNER
Authorized Official Telephone Number:
419-352-2569

Provider Taxonomy Codes

  • Taxonomy code: 1223G0001X , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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