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Individual

DR. GEORGE H. LIVERMORE III

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1595 HIGHWAY 34 E, NEWNAN, GA 30265-2353
(678) 206-2202
(678) 673-5155
Mailing address
925 N POINT PKWY, STE 130, ALPHARETTA, GA 30005-5210
(678) 206-2589
(678) 261-1713

Taxonomy

Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
036559
GA
207Y00000X
Otolaryngology Physician
36539
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
148497001
AR
01
184653
BCBS MO NUMBER
MO
05
209212901
MO
01
430741410
FIRST HEALTH NUMBER
MO
01
43074141063801A010
TRICARE NUMBER
MO
01
636259
HEALTHLINK NUMBER
MO
Enumeration date
01/05/2006
Last updated
12/16/2016
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