Healthcare Provider Details

I. General information

NPI: 1689518839
Provider Name (Legal Business Name): BRETT LIVINGSTON
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/17/2026
Last Update Date: 06/02/2026
Certification Date: 06/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8501 TANNER WILLIAMS RD
MOBILE AL
36608-8322
US

IV. Provider business mailing address

10763 PAGET DR N
MOBILE AL
36608-4197
US

V. Phone/Fax

Practice location:
  • Phone: 251-441-6560
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1710I1002X
TaxonomyIndependent Duty Corpsman
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: