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General NPI Number Information
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NPI Number | 1508191909
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Entity Type | Organization
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Legal Business Name | AMG LIVINGSTON LLC
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Dates
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Enumeration Date | 10/02/2009
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Last Update Date | 09/19/2025
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Provider Practice Location Address
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Address Line | 700 W MAIN ST
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City | LIVINGSTON
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State | TN
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Zip | 38570-1720
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Country | US
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Telephone | 931-823-9970
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Fax | 931-823-9006
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Provider Business Mailing Address
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Address Line | 700 W MAIN ST
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City | LIVINGSTON
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State | TN
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Zip | 38570-1720
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Country | US
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Telephone | 931-823-9970
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Fax | 931-823-9006
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | JOHNETTA TRAYLOR
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Credential |
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Telephone | 502-596-6063
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207VG0400X
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Taxonomy Name | Gynecology Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207VX0000X
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Taxonomy Name | Obstetrics Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 367A00000X
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Taxonomy Name | Advanced Practice Midwife
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License Number |
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License Number State |
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