Livengood, Joseph Charles

Livengood, Joseph Charles is an individual health care provider with primary practice located at 1650 Cowles St , Fairbanks AK 99701-5907. He recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as his primary health care specialty. Livengood, Joseph Charles can be contacted via phone (907) 458-5358.

Contact Information

Primary practice address
1650 Cowles St Fairbanks AK 99701-5907
Phone: (907) 458-5358
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X 37815 Colorado
Allopathic & Osteopathic Physicians / Surgery 208600000X MEDS7502 Alaska

Profile Details

NPI number 1518948447
LBN Legal business name Livengood, Joseph Charles
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 8th, 2005
Last updated Dec 1st, 2021 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1518948447 NPPES
Wyoming MEDICAID 116218700
Wyoming MEDICAID 69307563
Wyoming MEDICAID 1440711-01
Wyoming MEDICAID 1584760
Wyoming Other P00944662
Wyoming MEDICAID 84151469200

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