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Individual

DR. RICHARD WEAVER LIVINGSTON JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
363 N BELAIR RD, EVANS, GA 30809
(706) 650-7563
(706) 650-0512
Mailing address
PO BOX 2510, EVANS, GA 30809-2510
(706) 922-8251
(706) 922-6695

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
040724
GA
207Q00000X
Family Medicine Physician
Primary
40724
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00905099A
GA
01
10056154
AMERIGROUP
GA
01
336994
WELLCARE
GA
01
40724
LICENSE
GA
05
G40724
SC
Enumeration date
06/08/2006
Last updated
04/20/2026
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