Provider Demographics
NPI:1124217047
Name:DR PATRICK G LIVINGSTON PLLC
Entity Type:Organization
Organization Name:DR PATRICK G LIVINGSTON PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:GRAHAM
Authorized Official - Last Name:LIVINGSTON
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:405-321-0044
Mailing Address - Street 1:3400 W TECUMSEH RD
Mailing Address - Street 2:SUITE 106
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73072-1810
Mailing Address - Country:US
Mailing Address - Phone:405-321-0044
Mailing Address - Fax:
Practice Address - Street 1:3400 W TECUMSEH RD
Practice Address - Street 2:SUITE 106
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73072-1810
Practice Address - Country:US
Practice Address - Phone:405-321-0044
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-16
Last Update Date:2008-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OKH45389Medicare UPIN