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Individual

IAN R LIVINGSTONE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
269 S CANDY LN STE 107, COTTONWOOD, AZ 86326-4158
(928) 639-2251
Mailing address
1200 N BEAVER ST, PAYER CREDENTIALING, FLAGSTAFF, AZ 86001-3118
(928) 213-6235
(928) 213-6292

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
33029
AZ
2084N0400X
Neurology Physician
Primary
33029
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
892126
AZ
Enumeration date
10/02/2006
Last updated
10/06/2023
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