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General NPI Number Information
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NPI Number | 1558657643
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Entity Type | Individual
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Provider Name | JOSEPH GARY LIVINGSTON M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/27/2011
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Last Update Date | 07/30/2019
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Provider Practice Location Address
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Address Line | ONE BARNES-JEWSIH HOSPITAL PLAZA MAILSTOP 90-09-355
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City | SAINT LOUIS
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State | MO
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Zip | 63110
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Country | US
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Telephone | 314-724-1606
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Fax |
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Provider Business Mailing Address
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Address Line | ONE BARNES-JEWSIH HOSPITAL PLAZA MAILSTOP 90-09-355
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City | SAINT LOUIS
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State | MO
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Zip | 63110
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Country | US
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Telephone | 314-724-1606
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | C1-0011965
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License Number State | DE
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