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NPI Code Detail

MEDICARE: ROBERT L. LIVINGSTON, O.D.P.C.

MEDICARE: ROBERT L. LIVINGSTON, O.D.P.C.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1152W00000XOptometrist01647IA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
21932183720OTHERIANPI NUMBER

General Provider Information

NPI Number : 1144461864
Entity Type Code : Organization
Provider Name (Legal Business Name) : ROBERT L. LIVINGSTON, O.D.P.C.
Provider Business Mailing Address
First Line : PO BOX 317
Second Line :
City : SPIRIT LAKE
State : IA
Zip : 51360-0317
Country : US
Telephone Number : 712-336-8939
Fax Number : 712-336-8952
Provider Business Practice Location Address
First Line : 2600 HIGHWAY 9/71
Second Line :
City : SPIRIT LAKE
State : IA
Zip : 51360-7257
Country : US
Telephone Number : 712-336-8939
Fax Number : 712-336-8952
Authorized Official
Title or Position : DOCTOR
Name : DR. ROBERT LIVINGSTON
Credential : O.D.P.C.
Telephone Number : 712-336-8939
Provider Enumeration Date : 03/09/2009
Last Update Date : 03/09/2009

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