Basic Information
Provider Information
NPI: 1891718433
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: LEVINGS
FirstName: BRIAN
MiddleName: ALLEN
NamePrefix:  
NameSuffix:  
Credential: DO
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 8100 S WALKER AVE BLDG A
Address2:  
City: OKLAHOMA CITY
State: OK
PostalCode: 731399475
CountryCode: US
TelephoneNumber: 4056324468
FaxNumber: 4056320436
Practice Location
Address1: 8100 S WALKER AVE BLDG A
Address2:  
City: OKLAHOMA CITY
State: OK
PostalCode: 731399475
CountryCode: US
TelephoneNumber: 4056324468
FaxNumber: 4056320436
Other Information
ProviderEnumerationDate: 07/25/2006
LastUpdateDate: 07/10/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
202C00000X4207OKN Allopathic & Osteopathic PhysiciansIndependent Medical Examiner 
207XX0005X4207OKN Allopathic & Osteopathic PhysiciansOrthopaedic SurgerySports Medicine
207XX0801X4207OKN Allopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Trauma
207X00000X4207OKY Allopathic & Osteopathic PhysiciansOrthopaedic Surgery 

ID Information
IDTypeStateIssuerDescription
420701OKMEDICAL LICENSEOTHER


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