Individual provider · Type 1 NPI

Lawrence W. Livengood, PA

Surgical Physician Assistant · Charlottesville, VA

NPI number 1407067507 Active

Practice location

595 Martha Jefferson Dr Ste 180
Charlottesville, VA 22911-4669

Fax (434) 654-5574

Mailing address

PO Box 746550
Atlanta, GA 30374-6550

Specialties and licenses

TaxonomyCodeLicense
Physician Assistant 363A00000X1499 (TN)
Medical Physician Assistant 363AM0700X1499 (TN)
Surgical Physician Assistant 363AS0400X1449 (TN)
Surgical Physician Assistant Primary 363AS0400X0110004200 (VA)

Surgical Physician Assistant: Definition to come...

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About NPI 1407067507

Lawrence W. Livengood, PA's National Provider Identifier is 1407067507, issued on May 24, 2007. The primary taxonomy on file is Surgical Physician Assistant (363AS0400X), and the practice location is in Charlottesville, VA. The record was last updated on Aug 23, 2022.