# LIVESAY FAMILY MEDICINE, PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1932488327
- **Authorized official:** TOM D. LIVESAY MD (OWNER)
- **Authorized official phone:** (423) 419-5550

## Contact information

- **Practice address:** 200 NETTLETON RD STE 1, HARROGATE, TN 37752-8225
- **Practice address phone:** (423) 419-5550
- **Practice address fax:** (423) 419-5551
- **Mailing address:** 200 NETTLETON RD STE 1, HARROGATE, TN 37752-8225
- **Mailing address phone:** (423) 419-5550
- **Mailing address fax:** (423) 419-5550

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |
| 363LF0000X | Family Nurse Practitioner | — | NULL | — |
| 363LF0000X | Family Nurse Practitioner | — | — | — |

## Other

- **Enumeration date:** 08/16/2011
- **Last updated:** 03/12/2021