Healthcare Provider Details

I. General information

NPI: 1649528134
Provider Name (Legal Business Name): LLIVINA & HARRIGILL, M.D., P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/15/2012
Last Update Date: 08/15/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

48 MEDICAL PARK DR E SUITE 458
BIRMINGHAM AL
35235-3400
US

IV. Provider business mailing address

48 MEDICAL PARK DR E SUITE 458
BIRMINGHAM AL
35235-3400
US

V. Phone/Fax

Practice location:
  • Phone: 205-838-1811
  • Fax: 205-838-4252
Mailing address:
  • Phone: 205-838-1811
  • Fax: 205-838-4252

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. KEITH MARTIN HARRIGILL
Title or Position: PHYSICIAN
Credential: MD
Phone: 205-838-1811