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General NPI Number Information
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NPI Number | 1235292590
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Entity Type | Organization
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Legal Business Name | LIVINGSTON REGIONAL HOSPITAL
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Dates
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Enumeration Date | 12/18/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 315 OAK ST
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City | LIVINGSTON
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State | TN
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Zip | 38570-1728
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Country | US
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Telephone | 931-823-5611
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Fax |
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Provider Business Mailing Address
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Address Line | 315 OAK ST
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City | LIVINGSTON
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State | TN
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Zip | 38570-1728
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Country | US
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Telephone | 931-823-5611
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Fax |
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Authorized Official
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Title or Position | COO
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Name | MR. WILLIAM M GRACY
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Credential |
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Telephone | 615-372-8507
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number |
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License Number State |
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