Provider Demographics
NPI:1144399437
Name:STANFIELD, LORI LIVINGSTON (MD)
Entity Type:Individual
Prefix:DR
First Name:LORI
Middle Name:LIVINGSTON
Last Name:STANFIELD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:604 BRANTLEY ST
Mailing Address - Street 2:
Mailing Address - City:OPP
Mailing Address - State:AL
Mailing Address - Zip Code:36467-1742
Mailing Address - Country:US
Mailing Address - Phone:334-493-4472
Mailing Address - Fax:334-493-9849
Practice Address - Street 1:604 BRANTLEY ST
Practice Address - Street 2:
Practice Address - City:OPP
Practice Address - State:AL
Practice Address - Zip Code:36467-1742
Practice Address - Country:US
Practice Address - Phone:334-493-4472
Practice Address - Fax:334-493-9849
Is Sole Proprietor?:No
Enumeration Date:2006-11-08
Last Update Date:2007-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL21063207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL51035325OtherBLUE CROSS BLUE SHIELD
AL35325Medicaid
AL35325Medicaid