Provider Demographics
NPI:1003563818
Name:LIVOVICH, JEFFREY IRA (MD)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:IRA
Last Name:LIVOVICH
Suffix:
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 1:7276 E CRIMSON SKY TRL
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85266-4266
Mailing Address - Country:US
Mailing Address - Phone:480-250-4433
Mailing Address - Fax:
Practice Address - Street 1:7276 E CRIMSON SKY TRL
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85266-4266
Practice Address - Country:US
Practice Address - Phone:480-250-4433
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-02
Last Update Date:2022-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA00027138207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology