MEDICARE: DR. BELISE LIVINGSTON-BURNS MD

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
1	208000000X	Pediatrics Physician	ME93649	FL
2	208000000X	Pediatrics Physician	0544588	GA

General Provider Information

NPI Number	:	1740289545
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BELISE LIVINGSTON-BURNS MD

Provider Business Mailing Address
First Line	:	204 N WESTOVER BLVD
Second Line	:
City	:	ALBANY
State	:	GA
Zip	:	31707-2983
Country	:	US
Telephone Number	:	229-888-6559
Fax Number	:	229-436-4107

Provider Business Practice Location Address
First Line	:	1712-C EAST BROAD AVENUE
Second Line	:
City	:	ALBANY
State	:	GA
Zip	:	31705
Country	:	US
Telephone Number	:	229-639-3103
Fax Number	:	229-888-8935

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/14/2005
Last Update Date	:	03/07/2023

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Directions to “ DR. BELISE LIVINGSTON-BURNS MD” Practice Location

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