Provider Demographics
NPI:1093751471
Name:LIVINGSTON, TIM SCOTT (MD)
Entity type:Individual
Prefix:
First Name:TIM
Middle Name:SCOTT
Last Name:LIVINGSTON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:330 23RD AVE N STE 450
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37203-1661
Mailing Address - Country:US
Mailing Address - Phone:615-342-7339
Mailing Address - Fax:615-342-7340
Practice Address - Street 1:330 23RD AVE N STE 450
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37203-1661
Practice Address - Country:US
Practice Address - Phone:615-342-7339
Practice Address - Fax:615-342-7340
Is Sole Proprietor?:No
Enumeration Date:2006-06-22
Last Update Date:2022-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN370022084N0402X
NC2013-002442084N0402X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0402XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology with Special Qualifications in Child Neurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1093751471Medicaid
SCT83745Medicaid
SCAA01562389Medicare PIN
SCT83745Medicaid