Provider Demographics
NPI:1063739993
Name:LIVINGSTON, MICHAEL B (PHARMD)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:B
Last Name:LIVINGSTON
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6301 PALOMAR CT
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37211-7486
Mailing Address - Country:US
Mailing Address - Phone:615-771-8790
Mailing Address - Fax:
Practice Address - Street 1:305 SEABOARD LN
Practice Address - Street 2:SUITE 318
Practice Address - City:FRANKLIN
Practice Address - State:TN
Practice Address - Zip Code:37067-8287
Practice Address - Country:US
Practice Address - Phone:615-771-8790
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-05-03
Last Update Date:2010-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN10883183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist