Provider Demographics
NPI:1306898291
Name:LIVINGSTON, DAVID (MD)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:
Last Name:LIVINGSTON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3853 ANDREW JACKSON WAY
Mailing Address - Street 2:
Mailing Address - City:HERMITAGE
Mailing Address - State:TN
Mailing Address - Zip Code:37076
Mailing Address - Country:US
Mailing Address - Phone:615-498-2951
Mailing Address - Fax:
Practice Address - Street 1:321 BILLINGSLY CT
Practice Address - Street 2:SUITE 17
Practice Address - City:FRANKLIN
Practice Address - State:TN
Practice Address - Zip Code:37067-6444
Practice Address - Country:US
Practice Address - Phone:615-410-2292
Practice Address - Fax:866-788-0862
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-17
Last Update Date:2008-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD0000024082207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNF46795Medicare UPIN