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Individual
LAWRENCE W LIVENGOOD
Active
Individual
LAWRENCE W LIVENGOOD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
1499
TN
363AM0700X
Medical Physician Assistant
1499
TN
363AS0400X
Surgical Physician Assistant
Primary
0110004200
VA
363AS0400X
Surgical Physician Assistant
1449
TN
Other
Enumeration date
05/24/2007
Last updated
08/23/2022
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