Provider Demographics
NPI:1740289545
Name:LIVINGSTON-BURNS, BELISE (MD)
Entity type:Individual
Prefix:DR
First Name:BELISE
Middle Name:
Last Name:LIVINGSTON-BURNS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:BELISE
Other - Middle Name:L
Other - Last Name:LIVINGSTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:204 N WESTOVER BLVD
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:GA
Mailing Address - Zip Code:31707-2983
Mailing Address - Country:US
Mailing Address - Phone:229-888-6559
Mailing Address - Fax:229-436-4107
Practice Address - Street 1:1712-C EAST BROAD AVENUE
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:GA
Practice Address - Zip Code:31705
Practice Address - Country:US
Practice Address - Phone:229-639-3103
Practice Address - Fax:229-888-8935
Is Sole Proprietor?:No
Enumeration Date:2005-07-14
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME93649208000000X
GA0544588208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLBL9199666OtherFEDERAL DEA CERTIFICATE