Provider Demographics
NPI:1750551636
Name:JAMES A. LIVINGSTON, MD, PC
Entity type:Organization
Organization Name:JAMES A. LIVINGSTON, MD, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:A
Authorized Official - Last Name:LIVINGSTON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:478-956-3477
Mailing Address - Street 1:105 MOSELEY RD
Mailing Address - Street 2:PO BOX 999
Mailing Address - City:BYRON
Mailing Address - State:GA
Mailing Address - Zip Code:31008-7148
Mailing Address - Country:US
Mailing Address - Phone:478-956-3477
Mailing Address - Fax:478-956-4126
Practice Address - Street 1:105 MOSELEY RD
Practice Address - Street 2:
Practice Address - City:BYRON
Practice Address - State:GA
Practice Address - Zip Code:31008-7148
Practice Address - Country:US
Practice Address - Phone:478-956-3477
Practice Address - Fax:478-956-4126
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-06
Last Update Date:2008-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA020128174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty