Doctor Name: | DOUGLAS JOHN LIVINGSTON |
NPI Number: | 1245332600 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | DPM |
License Number: | 25MD00187800 |
Business Practice Address: | 2408 Riverton Rd Cinnaminson, NJ - 080773721 |
Business Phone Number: | 8568292101 |
Business Fax Number: | 8568293550 |
Mailing Address: | 570 Haddon Ave Ste C, COLLINGSWOOD |
State: | NJ |
Postal Code: | 081081449 |
Phone Number: | 8548331479 |
Fax Number: | 8568547969 |
NPI Enumeration Date: | 09/05/2006 |
NPI Last Update Date: | 06/08/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 213ES0103X |
License Number: | 25MD00187800 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NJ |
Taxonomy Type: | Podiatric Medicine & Surgery Service Providers |
Taxonomy Classification: | Podiatrist |
Taxonomy Specialization: | Foot & Ankle Surgery |
Taxonomy Definition: |