Provider Demographics
NPI:1013301068
Name:LEVINSKY, NICK CHARLES JR (MD)
Entity type:Individual
Prefix:
First Name:NICK
Middle Name:CHARLES
Last Name:LEVINSKY
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2695 ROCKY MOUNTAIN AVE STE 150
Mailing Address - Street 2:
Mailing Address - City:LOVELAND
Mailing Address - State:CO
Mailing Address - Zip Code:80538-9071
Mailing Address - Country:US
Mailing Address - Phone:970-624-2409
Mailing Address - Fax:970-490-4155
Practice Address - Street 1:2500 ROCKY MOUNTAIN AVE STE 2200
Practice Address - Street 2:
Practice Address - City:LOVELAND
Practice Address - State:CO
Practice Address - Zip Code:80538-9004
Practice Address - Country:US
Practice Address - Phone:970-203-7250
Practice Address - Fax:970-619-6094
Is Sole Proprietor?:No
Enumeration Date:2015-03-26
Last Update Date:2023-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101275435208600000X
390200000X
CODR.0071543208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program