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Organization

AMG-LIVINGSTON LLC

Active
Parent organization
AMG-LIVINGSTON LLC
Other names
Upper Cumberland Center for Women
Organization subpart
Yes

Provider details

NPI number
Legal business name
AMG-LIVINGSTON LLC
Authorized official
WILLIAM M GRACEY (COO)
(615) 372-8500
Entity
Organization

Contact information

Practice address
700 W MAIN ST, LIVINGSTON, TN 38570-1720
(931) 823-9970
(931) 823-9006
Mailing address
700 W MAIN ST, LIVINGSTON, TN 38570-1720
(931) 823-9970
(931) 823-9006

Taxonomy

Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
621753651
TAX ID
TN
Enumeration date
04/16/2008
Last updated
06/17/2008
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