Provider Demographics
NPI:1669468963
Name:DRS. LIGGETT, ROCKLIN & LIGGETT, INC.
Entity Type:Organization
Organization Name:DRS. LIGGETT, ROCKLIN & LIGGETT, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:TREASURER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:J
Authorized Official - Last Name:ROCKLIN
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:740-474-6039
Mailing Address - Street 1:401 N COURT ST
Mailing Address - Street 2:
Mailing Address - City:CIRCLEVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43113-3202
Mailing Address - Country:US
Mailing Address - Phone:740-474-6039
Mailing Address - Fax:740-477-2928
Practice Address - Street 1:401 N COURT ST
Practice Address - Street 2:
Practice Address - City:CIRCLEVILLE
Practice Address - State:OH
Practice Address - Zip Code:43113-3202
Practice Address - Country:US
Practice Address - Phone:740-474-6039
Practice Address - Fax:740-477-2928
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-22
Last Update Date:2010-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
No332H00000XSuppliersEyewear SupplierGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0001830Medicaid
LI9272901Medicare ID - Type Unspecified
OH0001830Medicaid