Provider Demographics
NPI:1912167115
Name:LIVINGSTON FAMILY HEALTHCARE LLC
Entity Type:Organization
Organization Name:LIVINGSTON FAMILY HEALTHCARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:DALE
Authorized Official - Last Name:BEATY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:931-403-5939
Mailing Address - Street 1:403 E UNIVERSITY ST
Mailing Address - Street 2:
Mailing Address - City:LIVINGSTON
Mailing Address - State:TN
Mailing Address - Zip Code:38570-1511
Mailing Address - Country:US
Mailing Address - Phone:931-403-5939
Mailing Address - Fax:931-403-5940
Practice Address - Street 1:403 E UNIVERSITY ST
Practice Address - Street 2:
Practice Address - City:LIVINGSTON
Practice Address - State:TN
Practice Address - Zip Code:38570-1511
Practice Address - Country:US
Practice Address - Phone:931-403-5939
Practice Address - Fax:931-403-5940
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-11
Last Update Date:2008-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN34968208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty