Healthcare Provider Details

I. General information

NPI: 1093751471
Provider Name (Legal Business Name): TIM SCOTT LIVINGSTON MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/22/2006
Last Update Date: 12/21/2022
Certification Date: 12/21/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

330 23RD AVE N STE 450
NASHVILLE TN
37203-1661
US

IV. Provider business mailing address

330 23RD AVE N STE 450
NASHVILLE TN
37203-1661
US

V. Phone/Fax

Practice location:
  • Phone: 615-342-7339
  • Fax: 615-342-7340
Mailing address:
  • Phone: 615-342-7339
  • Fax: 615-342-7340

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0402X
TaxonomyNeurology with Special Qualifications in Child Neurology Physician
License Number37002
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: