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General NPI Number Information
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NPI Number | 1144461864
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Entity Type | Organization
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Legal Business Name | ROBERT L. LIVINGSTON, O.D.P.C.
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Dates
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Enumeration Date | 03/09/2009
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Last Update Date | 03/09/2009
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Provider Practice Location Address
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Address Line | 2600 HIGHWAY 9/71
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City | SPIRIT LAKE
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State | IA
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Zip | 51360-7257
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Country | US
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Telephone | 712-336-8939
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Fax | 712-336-8952
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Provider Business Mailing Address
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Address Line | PO BOX 317
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City | SPIRIT LAKE
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State | IA
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Zip | 51360-0317
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Country | US
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Telephone | 712-336-8939
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Fax | 712-336-8952
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Authorized Official
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Title or Position | DOCTOR
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Name | DR. ROBERT LIVINGSTON
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Credential | O.D.P.C.
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Telephone | 712-336-8939
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 01647
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License Number State | IA
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