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Organization

AMG- LIVINGSTON LLC

Active
Parent organization
AMG-LIVINGSTON LLC
Other names
Overton Family Medical Center
Organization subpart
Yes

Provider details

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

Contact information

Practice address
529 MEDICAL DR, SUITE B, LIVINGSTON, TN 38570-1826
(931) 823-1266
(931) 823-7805
Mailing address
529 MEDICAL DR, SUITE B, LIVINGSTON, TN 38570-1826
(931) 823-1266
(931) 823-7805

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3716474
TN
Enumeration date
05/16/2006
Last updated
06/17/2008
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