Provider Demographics
NPI:1770308983
Name:SHELBY EAR NOSE AND THROAT PC, ASSOCIATES
Entity type:Organization
Organization Name:SHELBY EAR NOSE AND THROAT PC, ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:J
Authorized Official - Last Name:LIVINGSTON
Authorized Official - Suffix:III
Authorized Official - Credentials:MD
Authorized Official - Phone:205-621-8900
Mailing Address - Street 1:1228 1ST ST N
Mailing Address - Street 2:
Mailing Address - City:ALABASTER
Mailing Address - State:AL
Mailing Address - Zip Code:35007-8702
Mailing Address - Country:US
Mailing Address - Phone:205-621-8900
Mailing Address - Fax:205-621-7169
Practice Address - Street 1:1228 1ST ST N
Practice Address - Street 2:
Practice Address - City:ALABASTER
Practice Address - State:AL
Practice Address - Zip Code:35007-8702
Practice Address - Country:US
Practice Address - Phone:205-621-8900
Practice Address - Fax:205-621-7169
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-21
Last Update Date:2024-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Single Specialty